Provider Demographics
NPI:1356468235
Name:MOLAYEM, NILOUFAR ASHRAF (DDS)
Entity Type:Individual
Prefix:DR
First Name:NILOUFAR
Middle Name:ASHRAF
Last Name:MOLAYEM
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 1:1213 N LAKE AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3768
Mailing Address - Country:US
Mailing Address - Phone:626-798-7834
Mailing Address - Fax:626-798-6336
Practice Address - Street 1:1213 N LAKE AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-3768
Practice Address - Country:US
Practice Address - Phone:626-798-7834
Practice Address - Fax:626-798-6336
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist