Provider Demographics
NPI:1265156970
Name:ATASSI, MAHER (DMD)
Entity type:Individual
Prefix:
First Name:MAHER
Middle Name:
Last Name:ATASSI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 CAMINO DEL MAR
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2507
Mailing Address - Country:US
Mailing Address - Phone:858-504-5975
Mailing Address - Fax:
Practice Address - Street 1:1333 CAMINO DEL MAR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2507
Practice Address - Country:US
Practice Address - Phone:858-504-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0117411223P0700X
CA464531223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics