Provider Demographics
NPI:1902352891
Name:A. NIAZI, DDS, PLLC
Entity Type:Organization
Organization Name:A. NIAZI, DDS, PLLC
Other - Org Name:GIG HARBOR ENDODONTICS, PORT ORCHARD ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIAZI SHARAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-851-5544
Mailing Address - Street 1:5122 OLYMPIC DR NW
Mailing Address - Street 2:SUITE #B-101
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1767
Mailing Address - Country:US
Mailing Address - Phone:253-851-5544
Mailing Address - Fax:253-851-6561
Practice Address - Street 1:5122 OLYMPIC DR NW
Practice Address - Street 2:SUITE #B-101
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1767
Practice Address - Country:US
Practice Address - Phone:253-851-5544
Practice Address - Fax:253-851-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009574261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental