Provider Demographics
NPI:1164090288
Name:NASHED, MINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:NASHED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 MORNING SUN LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3327
Mailing Address - Country:US
Mailing Address - Phone:239-287-0190
Mailing Address - Fax:
Practice Address - Street 1:44790 MAYNARD SQ STE 180
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6515
Practice Address - Country:US
Practice Address - Phone:703-729-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25844122300000X
VA0401417483122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist