Provider Demographics
NPI:1356392161
Name:EMAMI, BABACK (DMD)
Entity type:Individual
Prefix:DR
First Name:BABACK
Middle Name:
Last Name:EMAMI
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 1:950 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3064
Mailing Address - Country:US
Mailing Address - Phone:781-963-2222
Mailing Address - Fax:781-963-1282
Practice Address - Street 1:950 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3064
Practice Address - Country:US
Practice Address - Phone:781-963-2222
Practice Address - Fax:781-963-1282
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19229122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist