Provider Demographics
NPI:1285942052
Name:SAFAVIAN, MEHRDAD (DDS)
Entity type:Individual
Prefix:
First Name:MEHRDAD
Middle Name:
Last Name:SAFAVIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 AVERY MUIRFIELD DR STE B
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1230
Mailing Address - Country:US
Mailing Address - Phone:614-789-9000
Mailing Address - Fax:614-789-9012
Practice Address - Street 1:6750 AVERY MUIRFIELD DR STE B
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1230
Practice Address - Country:US
Practice Address - Phone:614-789-9000
Practice Address - Fax:614-789-9012
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0233351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice