Provider Demographics
NPI:1891589941
Name:PAYMON A DORRI DDS PLLC
Entity type:Organization
Organization Name:PAYMON A DORRI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAYMON
Authorized Official - Middle Name:
Authorized Official - Last Name:DORRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-567-2479
Mailing Address - Street 1:25680 PONTIAC TRL STE 103
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-8046
Mailing Address - Country:US
Mailing Address - Phone:248-567-2479
Mailing Address - Fax:
Practice Address - Street 1:5761 MORGAN RD E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2659
Practice Address - Country:US
Practice Address - Phone:269-968-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty