Provider Demographics
NPI:1356325989
Name:ROWSHAN, HIRBOD (DDS)
Entity type:Individual
Prefix:
First Name:HIRBOD
Middle Name:
Last Name:ROWSHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12715 NE BEL RED RD STE 130
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2627
Mailing Address - Country:US
Mailing Address - Phone:425-454-5091
Mailing Address - Fax:425-454-5330
Practice Address - Street 1:12715 NE BEL RED RD STE 130
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2627
Practice Address - Country:US
Practice Address - Phone:425-454-5091
Practice Address - Fax:425-454-5330
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602437101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery