Provider Demographics
NPI:1235337619
Name:NADERI, YASSAMIN (DDS)
Entity Type:Individual
Prefix:MRS
First Name:YASSAMIN
Middle Name:
Last Name:NADERI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JASMINE
Other - Middle Name:
Other - Last Name:NADERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:16647 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-5088
Mailing Address - Country:US
Mailing Address - Phone:713-981-5500
Mailing Address - Fax:713-981-5507
Practice Address - Street 1:8303 SOUTHWEST FWY
Practice Address - Street 2:ST 855
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1600
Practice Address - Country:US
Practice Address - Phone:713-981-5500
Practice Address - Fax:713-981-5507
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice