Provider Demographics
NPI:1467479105
Name:ZANDI, ROXANA NAMDARI (DMD)
Entity Type:Individual
Prefix:MRS
First Name:ROXANA
Middle Name:NAMDARI
Last Name:ZANDI
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 1:10 ROBERT TONER BLVD.
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02763
Mailing Address - Country:US
Mailing Address - Phone:508-699-2299
Mailing Address - Fax:508-699-2213
Practice Address - Street 1:10 ROBERT TONER BLVD.
Practice Address - Street 2:
Practice Address - City:ATTLEBORO FALLS
Practice Address - State:MA
Practice Address - Zip Code:02763
Practice Address - Country:US
Practice Address - Phone:508-699-2299
Practice Address - Fax:508-699-2213
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist