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General NPI Number Information
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NPI Number | 1073069894
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Entity Type | Individual
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Provider Name | DR. NAVID KALANTARPOUR
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Gender | Male
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 12239 N CENTER AVE
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City | PORTLAND
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State | OR
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Zip | 97217-7806
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Country | US
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Telephone | 503-241-1800
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Fax | 503-241-1807
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Provider Business Mailing Address
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Address Line | 1607 SE 92ND CT
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City | VANCOUVER
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State | WA
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Zip | 98664
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Country | US
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Telephone | 360-449-2298
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D10512
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60658420
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License Number State | WA
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