Provider Demographics
NPI:1558517599
Name:SAATCHI, PASHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:PASHA
Middle Name:
Last Name:SAATCHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:PASHA
Other - Middle Name:
Other - Last Name:DJAVAHERI SAATCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:633 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5434
Mailing Address - Country:US
Mailing Address - Phone:718-499-6761
Mailing Address - Fax:718-499-6762
Practice Address - Street 1:633 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5434
Practice Address - Country:US
Practice Address - Phone:718-499-6761
Practice Address - Fax:718-499-6762
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03027649Medicaid