Provider Demographics
NPI:1154555894
Name:HAGHPANAH, MICHELLE MEHRI (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MEHRI
Last Name:HAGHPANAH
Suffix:
Gender:F
Credentials:DDS, MPH
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Mailing Address - Street 1:1480 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3612
Mailing Address - Country:US
Mailing Address - Phone:408-866-3000
Mailing Address - Fax:
Practice Address - Street 1:853 MIDDLEFIELD RD STE 2
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301
Practice Address - Country:US
Practice Address - Phone:650-322-9837
Practice Address - Fax:650-600-8019
Is Sole Proprietor?:No
Enumeration Date:2009-05-10
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0551411223P0221X, 1223P0221X
CA601621223P0221X, 1223P0221X
CT0101921223P0221X, 1223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program