Provider Demographics
NPI:1356505911
Name:STARNES, NAZIE KELISHADI (DDS)
Entity type:Individual
Prefix:
First Name:NAZIE
Middle Name:KELISHADI
Last Name:STARNES
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:SEYEDAH
Other - Middle Name:NAZANIN
Other - Last Name:KELISHADI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5912 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6232
Mailing Address - Country:US
Mailing Address - Phone:540-734-2390
Mailing Address - Fax:
Practice Address - Street 1:5912 PLANK RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6232
Practice Address - Country:US
Practice Address - Phone:540-734-2390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice