Provider Demographics
NPI:1497148209
Name:SARMAST, NISMAH SYEDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NISMAH
Middle Name:SYEDA
Last Name:SARMAST
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 1:6185 BUFORD HWY
Mailing Address - Street 2:BLDG. G
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2350
Mailing Address - Country:US
Mailing Address - Phone:770-446-0929
Mailing Address - Fax:
Practice Address - Street 1:6185 BUFORD HWY
Practice Address - Street 2:BLDG. G
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30071-2350
Practice Address - Country:US
Practice Address - Phone:770-446-0929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015275122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist