Provider Demographics
NPI:1982052973
Name:NAZARIAN, NEGIN (DDS)
Entity type:Individual
Prefix:DR
First Name:NEGIN
Middle Name:
Last Name:NAZARIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17190 NE 5TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-4132
Mailing Address - Country:US
Mailing Address - Phone:206-327-4136
Mailing Address - Fax:
Practice Address - Street 1:23515 NE NOVELTY HILL RD STE 209
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5505
Practice Address - Country:US
Practice Address - Phone:425-898-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13674122300000X
WADE607533411223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No122300000XDental ProvidersDentist