MEDICARE: NOROUZINIA PERIODONTICS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics

General Provider Information

NPI Number	:	1023814936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOROUZINIA PERIODONTICS, P.C.

Provider Business Mailing Address
First Line	:	9090 RIDGELINE BLVD STE 225
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2507
Country	:	US
Telephone Number	:	303-683-1144
Fax Number	:	303-683-1830

Provider Business Practice Location Address
First Line	:	9090 RIDGELINE BLVD STE 225
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-2507
Country	:	US
Telephone Number	:	303-683-1144
Fax Number	:	303-683-1830

Authorized Official
Title or Position	:	DOCTOR
Name	:	BAHMAN NOROUZINIA
Credential	:	DDS
Telephone Number	:	303-683-1144

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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