Healthcare Provider Details

I. General information

NPI: 1689879454
Provider Name (Legal Business Name): VAHID HOJREH D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VINNIE HOJREH DMD

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 W CAMELBACK RD
GLENDALE AZ
85303-6307
US

IV. Provider business mailing address

6740 W CAMELBACK RD
GLENDALE AZ
85303-6307
US

V. Phone/Fax

Practice location:
  • Phone: 623-247-5300
  • Fax: 623-247-1826
Mailing address:
  • Phone: 623-247-5300
  • Fax: 623-247-1826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4628
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: