Provider Demographics
NPI:1851507958
Name:PIETSCH, NASSIM G (DDS)
Entity Type:Individual
Prefix:DR
First Name:NASSIM
Middle Name:G
Last Name:PIETSCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NASSIM
Other - Middle Name:E
Other - Last Name:GHAVAMIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7030 35TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-5917
Mailing Address - Country:US
Mailing Address - Phone:206-523-1000
Mailing Address - Fax:
Practice Address - Street 1:7030 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-5917
Practice Address - Country:US
Practice Address - Phone:206-523-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000105771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice