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Contact Information

ELLIE HEYDARI, DDS
36745 AIKEN RD.
RED CLIFF COMMUNITY HEALTH CENTER
BAYFIELD, WI54814
 Phone: 715-779-3707
 Fax: 715-779-3622
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ELLIE HEYDARI · (Female)

NPI # 1518137652
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/05/2008
Last updated 02/10/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 2901017468
  • WI License # 7252-15
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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