PORTH
NPI 1962913509
Dentist - Orthodontics and Dentofacial Orthopedics in Sammamish, WA

Active since October 23, 2017
22620 SE 4TH ST STE 210, SAMMAMISH, WA 98074(425) 526-2060 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 23, 2020, Jun 16, 2018, Oct 23, 2017 (3 updates tracked since 2017).

About Porth NPPES

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

PORTH (NPI 1962913509) is a healthcare organization registered as an orthodontics and dentofacial orthopedics in Sammamish, Washington and active in the NPI registry since October 2017. The organization maintains a secondary practice location in Bellevue and lists Roozbeh Khosravi, Orthodontist, as its authorized official.

NPPES Registry Identity

NPI1962913509
Entity TypeOrganization
Primary Taxonomy1223X0400X
Legal Business NameROOZBEH KHOSRAVI DMD PHD LLC
Location Address22620 SE 4TH ST STE 210Sammamish, WA 98074-7375
Mailing Address22620 Se 4th St Ste 210Sammamish, WA 98074-7375 · (425) 526-2060
Organization SubpartNo
Authorized OfficialRoozbeh KhosraviOrthodontist · (617) 466-9090
Enumeration DateOctober 23, 2017
Last NPPES UpdateOctober 23, 20203 updates tracked since enumeration
NPPES CertifiedOctober 23, 2020
NPI 1962913509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
22620 SE 4TH ST STE 210, Sammamish, WA 98074

Other Names 1

Doing Business AsPorth

Secondary Practice Location 1

Location 114655 NE Bel Red Rd # F103Bellevue, WA 98007-3900 · Phone (425) 526-2060

Other Identifiers 1

Medicaid1629433891WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

Dentist (Orthodontics and Dentofacial Orthopedics)
22620 SE 4TH ST STE 210
SAMMAMISH, WA 98074

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 Roozbeh Khosravi Dmd Phd LLC's NPI number?

The NPI number for Roozbeh Khosravi Dmd Phd LLC is 1962913509. It was assigned to this organization in the NPPES registry on October 23, 2017. The provider is doing business as Porth.

Where is Roozbeh Khosravi Dmd Phd LLC located?

Roozbeh Khosravi Dmd Phd LLC is located at 22620 SE 4th St Ste 210, Sammamish, WA 98074. The listed phone number is (425) 526-2060.

What is Roozbeh Khosravi Dmd Phd LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Roozbeh Khosravi Dmd Phd LLC was last updated on October 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.