Provider Demographics
NPI:1184703423
Name:PIRNAZAR, NOUSHIN (DDS)
Entity type:Individual
Prefix:
First Name:NOUSHIN
Middle Name:
Last Name:PIRNAZAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4185 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611
Mailing Address - Country:US
Mailing Address - Phone:510-428-2003
Mailing Address - Fax:510-428-0641
Practice Address - Street 1:4185 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611
Practice Address - Country:US
Practice Address - Phone:510-428-2003
Practice Address - Fax:510-428-0641
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0366931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice