Provider Demographics
NPI:1821791575
Name:BASHARAT, NADIA (DDS)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:BASHARAT
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 1:176 E MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1763
Mailing Address - Country:US
Mailing Address - Phone:508-366-8300
Mailing Address - Fax:
Practice Address - Street 1:176 E MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1763
Practice Address - Country:US
Practice Address - Phone:508-366-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859746122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist