Provider Demographics
NPI:1396754651
Name:BEYRAMIAN, HASSAN (DDS)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:
Last Name:BEYRAMIAN
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 1:15033 W BELL RD
Mailing Address - Street 2:#175
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3217
Mailing Address - Country:US
Mailing Address - Phone:623-466-6322
Mailing Address - Fax:623-466-6325
Practice Address - Street 1:15033 W BELL RD
Practice Address - Street 2:#175
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3217
Practice Address - Country:US
Practice Address - Phone:623-466-6322
Practice Address - Fax:623-466-6325
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ63731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ909129Medicaid