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NPI Code Detail

MEDICARE: DR. GHASEM K DARIAN D.D.S.

MEDICARE:  DR. GHASEM K DARIAN  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
11223G0001XGeneral Practice Dentistry4354AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1416992OTHERAZAHCCCS
2976690OTHERAZUNITED CONCORDIA

General Provider Information

NPI Number : 1942363775
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GHASEM K DARIAN D.D.S.
Provider Business Mailing Address
First Line : 20165 N 67TH AVE STE 103
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7003
Country : US
Telephone Number : 623-931-5467
Fax Number : 623-931-5469
Provider Business Practice Location Address
First Line : 20165 N 67TH AVE STE 103
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7003
Country : US
Telephone Number : 623-931-5467
Fax Number : 623-931-5469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 04/17/2008

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Directions to “ DR. GHASEM K DARIAN D.D.S.” Practice Location

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