Provider Demographics
NPI:1306190731
Name:NASATIR, TERRIN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRIN
Middle Name:A
Last Name:NASATIR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E ALGONQUIN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4373
Mailing Address - Country:US
Mailing Address - Phone:847-640-1112
Mailing Address - Fax:847-510-0548
Practice Address - Street 1:434 W ONTARIO ST
Practice Address - Street 2:SUITE 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-7794
Practice Address - Country:US
Practice Address - Phone:312-475-9751
Practice Address - Fax:847-510-0548
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0292671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice