Provider Demographics
NPI:1487975868
Name:ZAHEDI, ARDALAN (DDS)
Entity type:Individual
Prefix:
First Name:ARDALAN
Middle Name:
Last Name:ZAHEDI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17600 TALBOT RD S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5788
Mailing Address - Country:US
Mailing Address - Phone:425-226-5940
Mailing Address - Fax:425-226-5941
Practice Address - Street 1:17600 TALBOT RD S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5788
Practice Address - Country:US
Practice Address - Phone:425-226-5940
Practice Address - Fax:425-226-5941
Is Sole Proprietor?:No
Enumeration Date:2010-06-19
Last Update Date:2010-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE606072881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice