Provider Demographics
NPI:1255824520
Name:NESAB, NAVID (DDS)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:
Last Name:NESAB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:MOHAMMADREZA
Other - Middle Name:
Other - Last Name:NASSABZADEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 JONES FERRY RD APT B10
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-2034
Mailing Address - Country:US
Mailing Address - Phone:919-360-3018
Mailing Address - Fax:
Practice Address - Street 1:7228 MONCURE PITTSBORO RD
Practice Address - Street 2:
Practice Address - City:MONCURE
Practice Address - State:NC
Practice Address - Zip Code:27559-9595
Practice Address - Country:US
Practice Address - Phone:919-542-4991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice