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Ebrahim Mirjalili, DDS
General Practice Dentistry in Buckley, Washington
NPI 1679650576

Ebrahim Mirjalili is a General Practice Dentistry based in Seattle, WA and is specialized in General Practice. Ebrahim Mirjalili practices in Buckley, WA and has the professional credentials of DDS. The NPI Number for Ebrahim Mirjalili is 1679650576 and holds a License No. DE00007824 (Washington).

The current practice location address for Ebrahim Mirjalili is 2120 Ryan Rd, Buckley, WA and can be reached out via phone at 360-829-4920.

Location: 2120 Ryan Rd, Buckley, WA, 98124-1703
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679650576
Provider Name
Ebrahim Mirjalili
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2120 Ryan Rd, Buckley, WA, 98124-1703
Phone Number
360-829-4920
Fax Number
Provider Enumeration Date
11/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5025234 05 WA
0175785 01 WA STATE LABOR & INDUSTRIES
MI9110 01 WA REGENCE BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
2120 Ryan Rd
City
Buckley
State
Washington
Zip
98321
Phone Number
360-829-4920
Fax Number
person
Provider Business Mailing Address Details
Address
2120 Ryan Rd
City
Buckley
State
Washington
Zip
98321
Phone Number
360-829-4920
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DE00007824 (Washington)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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