Provider Demographics
NPI:1508238478
Name:NASRESFAHANI, ZAHRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZAHRA
Middle Name:
Last Name:NASRESFAHANI
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 1:270 BABCOCK ST APT 21G
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-1028
Mailing Address - Country:US
Mailing Address - Phone:857-615-8145
Mailing Address - Fax:
Practice Address - Street 1:270 BABCOCK ST APT 21G
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1028
Practice Address - Country:US
Practice Address - Phone:857-615-8145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18567621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice