Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | D10420 | OR |
NPI | 1124411541 |
---|---|
Provider Name | Dr. Hujatullah Bayat |
First Address | Hillsboro, OR 97124-5611 |
Second Address | Tigard, OR 97223-8309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2015 |
Last Update Date | 14/07/2016 |