Provider Demographics
NPI:1801033949
Name:SANIEI-ABADEH, NILOUFAR (DDS)
Entity Type:Individual
Prefix:
First Name:NILOUFAR
Middle Name:
Last Name:SANIEI-ABADEH
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 1:6848 CALLE ALTAMIRA
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-5711
Mailing Address - Country:US
Mailing Address - Phone:925-846-8364
Mailing Address - Fax:
Practice Address - Street 1:6848 CALLE ALTAMIRA
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5711
Practice Address - Country:US
Practice Address - Phone:925-846-8364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice