MEDICARE: DR. SAFA IRANPOUR D.D.S.

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	122300000X	Dentist	19430	OH

General Provider Information

NPI Number	:	1598983165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAFA IRANPOUR D.D.S.

Provider Business Mailing Address
First Line	:	4370 RIDGE RD
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-2717
Country	:	US
Telephone Number	:	216-749-0747
Fax Number	:	216-739-9544

Provider Business Practice Location Address
First Line	:	4370 RIDGE RD
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-2717
Country	:	US
Telephone Number	:	216-749-0747
Fax Number	:	216-739-9544

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	04/09/2026

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