Provider Demographics
NPI:1336937309
Name:SAFFARI DENTAL GROUP PLLC
Entity type:Organization
Organization Name:SAFFARI DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFFARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-716-6849
Mailing Address - Street 1:1 GIBSON WAY APT 637
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-2474
Mailing Address - Country:US
Mailing Address - Phone:503-716-6849
Mailing Address - Fax:
Practice Address - Street 1:372 WASHINGTON ST STE 2500
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6216
Practice Address - Country:US
Practice Address - Phone:781-226-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty