Provider Demographics
NPI:1700821485
Name:ASHOURI, NAHAL (DDS, MS)
Entity Type:Individual
Prefix:
First Name:NAHAL
Middle Name:
Last Name:ASHOURI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SOUTH DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4212
Mailing Address - Country:US
Mailing Address - Phone:650-961-5047
Mailing Address - Fax:505-961-0624
Practice Address - Street 1:505 SOUTH DR
Practice Address - Street 2:SUITE 8
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4212
Practice Address - Country:US
Practice Address - Phone:650-961-5047
Practice Address - Fax:650-961-0624
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA487841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics