Provider Demographics
NPI:1043263585
Name:FAGHIH-NAKHJIRI, SIMIN (DDS, MSD, MS)
Entity type:Individual
Prefix:DR
First Name:SIMIN
Middle Name:
Last Name:FAGHIH-NAKHJIRI
Suffix:
Gender:F
Credentials:DDS, MSD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34709 9TH AVE S
Mailing Address - Street 2:SUITE B-300
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8722
Mailing Address - Country:US
Mailing Address - Phone:253-874-2583
Mailing Address - Fax:253-874-8957
Practice Address - Street 1:34709 9TH AVE S
Practice Address - Street 2:SUITE B-300
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8722
Practice Address - Country:US
Practice Address - Phone:253-874-2583
Practice Address - Fax:253-874-8957
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8860991Medicare PIN
WAV09860Medicare UPIN