Provider Demographics
NPI:1790804318
Name:VARASTEH, VAHID (DMD)
Entity Type:Individual
Prefix:DR
First Name:VAHID
Middle Name:
Last Name:VARASTEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1367
Mailing Address - Country:US
Mailing Address - Phone:978-664-5901
Mailing Address - Fax:978-945-6360
Practice Address - Street 1:240 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1367
Practice Address - Country:US
Practice Address - Phone:978-664-5901
Practice Address - Fax:978-945-6360
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice