Provider Demographics
NPI:1235709726
Name:KASEMI, IGLI (DMD)
Entity Type:Individual
Prefix:
First Name:IGLI
Middle Name:
Last Name:KASEMI
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 1:711 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-1134
Mailing Address - Country:US
Mailing Address - Phone:857-756-2733
Mailing Address - Fax:
Practice Address - Street 1:501 GLOUCESTER CROSSING RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2289
Practice Address - Country:US
Practice Address - Phone:978-675-2399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859539122300000X
MEDEN48831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice