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NPI Code Detail

MEDICARE: ASHKAN SHAYEGAN DMD PC

MEDICARE: ASHKAN SHAYEGAN DMD PC
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1750047643
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASHKAN SHAYEGAN DMD PC
Provider Business Mailing Address
First Line : 5861 SW BEAVERTON HILLSDALE HWY
Second Line :
City : PORTLAND
State : OR
Zip : 97221-1925
Country : US
Telephone Number : 503-292-5483
Fax Number : 503-297-5015
Provider Business Practice Location Address
First Line : 5861 SW BEAVERTON HILLSDALE HWY
Second Line :
City : PORTLAND
State : OR
Zip : 97221-1925
Country : US
Telephone Number : 503-292-5483
Fax Number : 503-297-5015
Authorized Official
Title or Position : PRESIDENT
Name : DR. ASHKAN SHAYEGAN
Credential : DMD
Telephone Number : 480-229-2086
Provider Enumeration Date : 11/15/2021
Last Update Date : 11/15/2021

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Directions to “ASHKAN SHAYEGAN DMD PC ” Practice Location

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