Provider Demographics
NPI:1326360652
Name:KARIMIPOUR-SARYAZDI, MEHDI (DMD)
Entity Type:Individual
Prefix:
First Name:MEHDI
Middle Name:
Last Name:KARIMIPOUR-SARYAZDI
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 1:25 BUTTRICK RD STE C1
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3353
Mailing Address - Country:US
Mailing Address - Phone:603-965-3407
Mailing Address - Fax:
Practice Address - Street 1:25 BUTTRICK RD STE C1
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3353
Practice Address - Country:US
Practice Address - Phone:603-965-3407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH041281223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics