MEDICARE: HONAR SALEH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D012796	AZ

General Provider Information

NPI Number	:	1467382317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONAR SALEH

Provider Business Mailing Address
First Line	:	6332 SUNNYWOOD DR
Second Line	:
City	:	ANTIOCH
State	:	TN
Zip	:	37013-4466
Country	:	US
Telephone Number	:	615-485-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	3699 HWAY 95 STE 316B
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-9123
Country	:	US
Telephone Number	:	928-955-4053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ HONAR SALEH ” Practice Location

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