Provider Demographics
NPI:1770824575
Name:ALIAKBAR ESMAEILI DDS LLC
Entity Type:Organization
Organization Name:ALIAKBAR ESMAEILI DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALIAKBAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAEILI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-767-3860
Mailing Address - Street 1:49 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1766
Mailing Address - Country:US
Mailing Address - Phone:781-609-2082
Mailing Address - Fax:
Practice Address - Street 1:4238 WASHINGTON ST
Practice Address - Street 2:UNIT C
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-2517
Practice Address - Country:US
Practice Address - Phone:917-767-3860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18550961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty