Individual
DR. MEHRAN ENAYATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15280 NW CENTRAL DR, SUITE 201, PORTLAND, OR 97229-7805
(503) 533-8240
(503) 533-8320
Mailing address
15280 NW CENTRAL DR, SUITE 201, PORTLAND, OR 97229-7805
(503) 533-8240
(503) 533-8320
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
D7039
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7039
DENTAL LICENSE NUMBER
OR
Enumeration date
02/22/2007
Last updated
07/08/2007
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