Healthcare Provider Details

I. General information

NPI: 1891919775
Provider Name (Legal Business Name): CAMRAN SAIED ZAFARNIA D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12819 120TH AVE NE SUITE I
KIKLAND WA
98034
US

IV. Provider business mailing address

12819 120TH AVE NE SUITE I
KIKLAND WA
98034
US

V. Phone/Fax

Practice location:
  • Phone: 425-803-0400
  • Fax: 425-803-3368
Mailing address:
  • Phone: 425-803-0400
  • Fax: 425-803-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00007384
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: