Provider Demographics
NPI:1053812081
Name:AFSHAR, ARMIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ARMIN
Middle Name:
Last Name:AFSHAR
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 1:4817 RIVER RD N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-4537
Mailing Address - Country:US
Mailing Address - Phone:541-224-6924
Mailing Address - Fax:
Practice Address - Street 1:2815 WILLETTA ST SW STE A1
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-3448
Practice Address - Country:US
Practice Address - Phone:541-201-2971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD112801223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry