Provider Demographics
NPI:1255462057
Name:BIRIA, FIROOZEH (DDS)
Entity type:Individual
Prefix:DR
First Name:FIROOZEH
Middle Name:
Last Name:BIRIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5403 W 134TH TER
Mailing Address - Street 2:#1528
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-4288
Mailing Address - Country:US
Mailing Address - Phone:913-681-3071
Mailing Address - Fax:
Practice Address - Street 1:10616 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1651
Practice Address - Country:US
Practice Address - Phone:913-888-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS603751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice