Provider Demographics
NPI:1942866645
Name:ASSADI, MAHSHID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHSHID
Middle Name:
Last Name:ASSADI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MAHSHID
Other - Middle Name:A
Other - Last Name:MALEKZADEH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4300 LONG BEACH BLVD STE 415
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2017
Mailing Address - Country:US
Mailing Address - Phone:562-423-0800
Mailing Address - Fax:
Practice Address - Street 1:4300 LONG BEACH BLVD STE 415
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2017
Practice Address - Country:US
Practice Address - Phone:562-423-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice