Darioush Afshar

Individual provider Active NPI General Practice Dentistry · Salem, OR

NPI 1306226782 · NPPES record last updated Jun 1, 2015

Key facts

NPI
1306226782
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D10236 (OR)
Practice address
4392 Liberty Rd S
Salem, OR 97302-6171
Phone
(971) 373-4583
NPI assigned
Jun 1, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D10236ORMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10236 OR Yes

Addresses

Primary practice location

4392 Liberty Rd S
Salem, OR 97302-6171

Mailing address

1556 Kamela Dr S
Salem, OR 97306-2249

Other providers in Salem, OR

All providers in Salem, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.