Provider Demographics
NPI:1396886594
Name:YAZDI, NESHAT (DDS)
Entity type:Individual
Prefix:
First Name:NESHAT
Middle Name:
Last Name:YAZDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N SHEPHERD DR STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-6500
Mailing Address - Country:US
Mailing Address - Phone:713-864-3993
Mailing Address - Fax:713-426-2498
Practice Address - Street 1:915 N SHEPHERD DR STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-6500
Practice Address - Country:US
Practice Address - Phone:713-864-3993
Practice Address - Fax:713-426-2498
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice