Provider Demographics
NPI:1497851851
Name:ARSHADI, EFTEKHAR (DMD)
Entity Type:Individual
Prefix:
First Name:EFTEKHAR
Middle Name:
Last Name:ARSHADI
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 1:2171 SIESTA DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5235
Mailing Address - Country:US
Mailing Address - Phone:941-556-9538
Mailing Address - Fax:941-706-4348
Practice Address - Street 1:2171 SIESTA DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5235
Practice Address - Country:US
Practice Address - Phone:941-556-9538
Practice Address - Fax:941-706-4348
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14696122300000X
MA18605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX07514OtherBLUE CROSS BLUE SHIELD
MA0278815OtherMASS HEALTH