Provider Demographics
NPI:1518459544
Name:NASIR, SANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANA
Middle Name:
Last Name:NASIR
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 1:9384 COLBERT CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2000
Mailing Address - Country:US
Mailing Address - Phone:703-867-4676
Mailing Address - Fax:
Practice Address - Street 1:10910 LITTLE PATUXENT PKWY STE 103R
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3081
Practice Address - Country:US
Practice Address - Phone:410-992-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD169241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program