1. Home
  2. Directory
  3. Washington
  4. Kent
  5. Dentist
  6. NPI Profile

KOOROUSH MANSOURZADEH D.D.S.
NPI 1417309790
Dentist in Kent, WA

Active since July 11, 2016
12906 SE KENT KANGLEY RD, KENT, WA 98030(253) 361-3015 Get Directions Write a Review

NPPES record last updated: July 11, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kooroush Mansourzadeh D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOOROUSH MANSOURZADEH D.D.S. (NPI 1417309790) is an individual dentist in Kent, Washington, licensed in Washington (DE60655131) and active in the NPI registry since July 2016.

NPPES Registry Identity

NPI1417309790
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameKOOROUSH MANSOURZADEHCredential: D.D.S.
Location Address12906 SE KENT KANGLEY RDKent, WA 98030-7940
Mailing Address12906 Se Kent Kangley RdKent, WA 98030-7940
Phone(253) 361-3015
Sole ProprietorYes
Enumeration DateJuly 11, 2016
✔ NPI 1417309790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WA · DE60655131
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
12906 SE KENT KANGLEY RD, Kent, WA 98030
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Combined Life, Humana, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKE MERIDIAN DENTAL LLC
Dentist
12906 SE KENT KANGLEY RD
KENT, WA 98030
King County (253) 631-3015
PAUL CAMPBELL
Dentist (General Practice)
12906 SE KENT KANGLEY RD
KENT, WA 98030
King County (253) 342-4171

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kooroush Mansourzadeh's NPI number?

The NPI number for Kooroush Mansourzadeh is 1417309790. It was assigned to this individual provider in the NPPES registry on July 11, 2016.

Where is Kooroush Mansourzadeh located?

Kooroush Mansourzadeh practices at 12906 SE Kent Kangley Rd, Kent, WA 98030. The listed phone number is (253) 361-3015.

What is Kooroush Mansourzadeh's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

What insurance does Kooroush Mansourzadeh accept?

Health plans from Florida Combined Life, Humana and Premera Blue Cross Blue Shield of Alaska list Kooroush Mansourzadeh as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kooroush Mansourzadeh was last updated on July 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.