Provider Demographics
NPI:1558569301
Name:ASBAHI, RAZAN SALAHI (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:RAZAN
Middle Name:SALAHI
Last Name:ASBAHI
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45765 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8581
Mailing Address - Country:US
Mailing Address - Phone:734-454-6626
Mailing Address - Fax:603-288-8524
Practice Address - Street 1:2138 MADISON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43624-1131
Practice Address - Country:US
Practice Address - Phone:419-241-1644
Practice Address - Fax:419-249-6581
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022490122300000X
MI2901019117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist