Provider Demographics
NPI:1730979469
Name:BARZEGARI SISAN, PANIZ (DDS)
Entity type:Individual
Prefix:MS
First Name:PANIZ
Middle Name:
Last Name:BARZEGARI SISAN
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 176TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-7480
Mailing Address - Country:US
Mailing Address - Phone:425-635-8062
Mailing Address - Fax:
Practice Address - Street 1:918 SE 164TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9603
Practice Address - Country:US
Practice Address - Phone:360-260-1005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program