Provider Demographics
NPI:1245565159
Name:TARASSOLI, YASAMIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:YASAMIN
Middle Name:
Last Name:TARASSOLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 ARNOLD DR STE C
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4111
Mailing Address - Country:US
Mailing Address - Phone:925-229-3232
Mailing Address - Fax:925-228-1420
Practice Address - Street 1:1175 ARNOLD DR STE C
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4111
Practice Address - Country:US
Practice Address - Phone:925-229-3232
Practice Address - Fax:925-228-1420
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist