Provider Demographics
NPI:1902395890
Name:TABARI, NEGAR NORA (DMD)
Entity Type:Individual
Prefix:
First Name:NEGAR
Middle Name:NORA
Last Name:TABARI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NEGAR
Other - Middle Name:
Other - Last Name:ZEIAE BAKHSH TABARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:248 N FULLERTON AVE # NJ07042
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3909
Mailing Address - Country:US
Mailing Address - Phone:423-737-6370
Mailing Address - Fax:
Practice Address - Street 1:176 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1310
Practice Address - Country:US
Practice Address - Phone:201-525-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027438021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry