Healthcare Provider Details

I. General information

NPI: 1528993318
Provider Name (Legal Business Name): BIPAR DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 E SHEA BLVD STE 150
PHOENIX AZ
85028-4256
US

IV. Provider business mailing address

4611 E SHEA BLVD STE 150
PHOENIX AZ
85028-4256
US

V. Phone/Fax

Practice location:
  • Phone: 602-494-1448
  • Fax: 602-825-1654
Mailing address:
  • Phone: 602-494-1448
  • Fax: 602-825-1654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PAYAM BIPAR
Title or Position: OPERATING MANAGER
Credential:
Phone: 602-494-1448