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General NPI Number Information
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NPI Number | 1295949915
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Entity Type | Individual
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Provider Name | MEHRDAD MOSTAFAEIPOUR D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 04/12/2018
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Provider Practice Location Address
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Address Line | 6392 SPRING MOUNTAIN RD
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City | LAS VEGAS
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State | NV
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Zip | 89146-8806
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Country | US
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Telephone | 702-871-0304
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 DOUBLE ARCH CT
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City | LAS VEGAS
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State | NV
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Zip | 89128-8485
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Country | US
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Telephone | 702-338-8550
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Fax | 702-363-8951
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3720
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License Number State | NV
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