Provider Demographics
NPI:1588682140
Name:MOAVENIAN, NADER (DDS)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:MOAVENIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TRAFALGAR SQ STE 201
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-4901
Mailing Address - Country:US
Mailing Address - Phone:603-595-8889
Mailing Address - Fax:603-595-2027
Practice Address - Street 1:33 TRAFALGAR SQ STE 201
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-4901
Practice Address - Country:US
Practice Address - Phone:603-595-8889
Practice Address - Fax:603-595-2027
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH32161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3216OtherSTATE DENTAL LISENCE
NARE7752Medicare ID - Type Unspecified
NH3216OtherSTATE DENTAL LISENCE