Mazyar Afshar, DMD
Individual provider Active NPI General Practice Dentistry · Beaverton, OR
NPI 1942510458 · NPPES record last updated Oct 18, 2010
Key facts
- NPI
- 1942510458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D9478 (OR)
- Practice address
- 12575 SW 3Rd St
Beaverton, OR 97005-0517 - Phone
- (503) 644-7697
- NPI assigned
- Oct 18, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9478 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Family Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D9478 | OR | Yes |
Addresses
Primary practice location
12575 SW 3Rd St
Beaverton, OR 97005-0517
Mailing address
12575 SW 3Rd St
Beaverton, OR 97005-0517
Phone (503) 644-7697
Other providers in Beaverton, OR
- Kassie Austyn Adolph
- Adriane Knorr, ND LLC
- Melody Adyani
- Aegis Group Practice LLC
- Affectus Counseling
- Agape21 Residential Treatment Home
- Agewell Geriatrics, LLC
- Casey Aglietti
- Agm Hospice Care 1, LLC
- Agora Corporation
All providers in Beaverton, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.