Provider Demographics
NPI:1578853313
Name:BASSIRI & ASSOCIATES, PA
Entity Type:Organization
Organization Name:BASSIRI & ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BASSIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-983-0095
Mailing Address - Street 1:226 KIRBY RD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-9492
Mailing Address - Country:US
Mailing Address - Phone:336-983-0095
Mailing Address - Fax:336-983-0588
Practice Address - Street 1:226 KIRBY RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9492
Practice Address - Country:US
Practice Address - Phone:336-983-0095
Practice Address - Fax:336-983-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty