Provider Demographics
NPI:1457838294
Name:LOTFIZADEH DEHKORDI, NARGES (DDS)
Entity type:Individual
Prefix:DR
First Name:NARGES
Middle Name:
Last Name:LOTFIZADEH DEHKORDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NARGES
Other - Middle Name:
Other - Last Name:LOTFI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:23925 225TH WAY SE STE A
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-5291
Mailing Address - Country:US
Mailing Address - Phone:425-432-0561
Mailing Address - Fax:
Practice Address - Street 1:23925 225TH WAY SE STE A
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5291
Practice Address - Country:US
Practice Address - Phone:425-432-0561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60874723122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1790172625OtherNPI TYPE 2