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Individual

DR. REZA HESHMATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8916
(503) 494-6783
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8916
(503) 494-6783

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
61262027
WA
1223P0700X
Prosthodontics
71-0000152
OH
1223P0700X
Prosthodontics
Primary
D12059
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2276504
OH
Enumeration date
12/19/2006
Last updated
02/24/2026
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