Provider Demographics
NPI:1821723719
Name:DEHBASHI, SEPEHR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEPEHR
Middle Name:
Last Name:DEHBASHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 WILSHIRE DR APT 210
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1752
Mailing Address - Country:US
Mailing Address - Phone:248-225-4143
Mailing Address - Fax:
Practice Address - Street 1:3231 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3635
Practice Address - Country:US
Practice Address - Phone:248-260-2927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist