Provider Demographics
NPI:1245458819
Name:NAVIDI, BABAK
Entity type:Individual
Prefix:DR
First Name:BABAK
Middle Name:
Last Name:NAVIDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3663 E SUNSET RD STE 301
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3246
Mailing Address - Country:US
Mailing Address - Phone:702-450-5999
Mailing Address - Fax:702-450-9501
Practice Address - Street 1:3663 E SUNSET RD STE 301
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3246
Practice Address - Country:US
Practice Address - Phone:702-450-5999
Practice Address - Fax:702-450-9501
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV42891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice