Provider Demographics
NPI:1336211556
Name:TAHVILI, ZAHRA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZAHRA
Middle Name:
Last Name:TAHVILI
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 1:420 WILLIAMSON WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1251
Mailing Address - Country:US
Mailing Address - Phone:541-488-9260
Mailing Address - Fax:541-488-7465
Practice Address - Street 1:420 WILLIAMSON WAY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1251
Practice Address - Country:US
Practice Address - Phone:541-488-9260
Practice Address - Fax:541-488-7465
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD70241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice