Provider Demographics
NPI:1336160472
Name:DARABI, DARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARA
Middle Name:
Last Name:DARABI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BICENTENNIAL HWY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1900
Mailing Address - Country:US
Mailing Address - Phone:413-782-6777
Mailing Address - Fax:413-782-6784
Practice Address - Street 1:275 BICENTENNIAL HWY
Practice Address - Street 2:SUITE 207
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1900
Practice Address - Country:US
Practice Address - Phone:413-782-6777
Practice Address - Fax:413-782-6784
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208641223G0001X
MADN20864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice