Provider Demographics
NPI:1861177917
Name:BARZANGY, RUNAZ (DMD)
Entity type:Individual
Prefix:DR
First Name:RUNAZ
Middle Name:
Last Name:BARZANGY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 MEADOWS RD STE 131
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2622
Mailing Address - Country:US
Mailing Address - Phone:503-334-0351
Mailing Address - Fax:
Practice Address - Street 1:4823 MEADOWS RD STE 131
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2622
Practice Address - Country:US
Practice Address - Phone:503-334-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD118001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice