Provider Demographics
NPI:1851399059
Name:BASHI, VAHID H (DDS)
Entity Type:Individual
Prefix:DR
First Name:VAHID
Middle Name:H
Last Name:BASHI
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 1:6425 WALL ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8335
Mailing Address - Country:US
Mailing Address - Phone:719-528-8292
Mailing Address - Fax:719-522-0288
Practice Address - Street 1:6425 WALL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8335
Practice Address - Country:US
Practice Address - Phone:719-528-8292
Practice Address - Fax:719-522-0288
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO82761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice