Provider Demographics
NPI:1841429776
Name:VAZIRI, HAMED (ORTHODONTICS)
Entity type:Individual
Prefix:
First Name:HAMED
Middle Name:
Last Name:VAZIRI
Suffix:
Gender:M
Credentials:ORTHODONTICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 FARMINGTON AVE UNIT 206
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1743
Mailing Address - Country:US
Mailing Address - Phone:774-280-2543
Mailing Address - Fax:
Practice Address - Street 1:730 FARMINGTON AVE UNIT 206
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1743
Practice Address - Country:US
Practice Address - Phone:774-280-2543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX289881223X0400X
CT0107401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics