Provider Demographics
NPI:1891199899
Name:FERDOWSI, BAYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BAYAN
Middle Name:
Last Name:FERDOWSI
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 1:201 SIGNATURE PL
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3376
Mailing Address - Country:US
Mailing Address - Phone:615-444-7999
Mailing Address - Fax:
Practice Address - Street 1:201 SIGNATURE PL
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3376
Practice Address - Country:US
Practice Address - Phone:615-444-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice