Provider Demographics
NPI:1588852602
Name:SEKANDARI, NAHID (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAHID
Middle Name:
Last Name:SEKANDARI
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 1:5700 W OLIVE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-3147
Mailing Address - Country:US
Mailing Address - Phone:623-934-7606
Mailing Address - Fax:623-934-0150
Practice Address - Street 1:5700 W OLIVE AVE STE 104
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-3147
Practice Address - Country:US
Practice Address - Phone:623-934-7606
Practice Address - Fax:623-934-0150
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD077431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice