# NIMA FOROUTAN DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699130211
- **Authorized official:** DR. NIMA FOROUTAN (DENTIST)
- **Authorized official phone:** (425) 786-8879

## Contact information

- **Practice address:** 410 BELLEVUE WAY SE STE 102, BELLEVUE, WA 98004-6649
- **Practice address phone:** (425) 454-3833
- **Practice address fax:** (425) 635-9312
- **Mailing address:** 410 BELLEVUE WAY SE STE 102, BELLEVUE, WA 98004-6649
- **Mailing address phone:** (425) 454-3833
- **Mailing address fax:** (425) 635-9312

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE60384118 | WA | Yes |

## Other

- **Enumeration date:** 12/24/2015
- **Last updated:** 12/24/2015