Provider Demographics
NPI:1740889849
Name:ALALEH MOAZAMI DMD PLLC
Entity type:Organization
Organization Name:ALALEH MOAZAMI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOAZAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:971-271-0255
Mailing Address - Street 1:7315 NE 141ST ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-9739
Mailing Address - Country:US
Mailing Address - Phone:425-636-8700
Mailing Address - Fax:
Practice Address - Street 1:7315 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-9739
Practice Address - Country:US
Practice Address - Phone:425-636-8700
Practice Address - Fax:425-896-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental