Provider Demographics
NPI:1720106529
Name:DARVISH, NAHAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:NAHAL
Middle Name:
Last Name:DARVISH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 148TH ST SE
Mailing Address - Street 2:ND ORTHODONTICS SUITE 203
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012
Mailing Address - Country:US
Mailing Address - Phone:425-379-6200
Mailing Address - Fax:425-379-6226
Practice Address - Street 1:3922 148TH ST SE
Practice Address - Street 2:ND ORTHODONTICS SUITE 203
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012
Practice Address - Country:US
Practice Address - Phone:425-379-6200
Practice Address - Fax:425-379-6226
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000099931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics