DR. BEHNAM FAKHRAVAR DMD MS NPI 1700164969

NPI Information

NPI: 1700164969
Provider Name: DR. BEHNAM FAKHRAVAR, DMD, MS
Classification: Dentist - 1223P0300X
Entity Type: Individual

Specialization: Periodontics

PECOS Registration: Yes

Address:
322 SE 192ND AVE STE 100
VANCOUVER, WA
ZIP 98683
Phone: (219) 360-9587
Get Directions

DR. Behnam Fakhravar, DMD, MS is a periodontics dentist in Vancouver, WA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DR. Behnam Fakhravar, DMD, MS NPI is 1700164969. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

322 SE 192ND AVE STE 100
VANCOUVER, WA
ZIP 98683-679
Phone: (219) 360-9587

The NPI 1700164969 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/21/2011 and was last updated on 2/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0300X	Dentist	Periodontics	DDS61887	CALIFORNIA	No
2	1223P0300X	Dentist	Periodontics	1001779	WISCONSIN	No
3	1223P0300X	Dentist	Periodontics	28573	TEXAS	No
4	1223P0300X	Dentist	Periodontics	D9565	OREGON	No
5	1223P0300X	Dentist	Periodontics	DE60231686	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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