Provider Demographics
NPI:1750064135
Name:MEHR AND NGUYEN RE, LLC
Entity type:Organization
Organization Name:MEHR AND NGUYEN RE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BAHRUM
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-734-8082
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-0528
Mailing Address - Country:US
Mailing Address - Phone:206-718-4449
Mailing Address - Fax:
Practice Address - Street 1:1901 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1015
Practice Address - Country:US
Practice Address - Phone:253-756-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental