Provider Demographics
NPI:1457419483
Name:TAIYARI, NADIA (DDS)
Entity Type:Individual
Prefix:MS
First Name:NADIA
Middle Name:
Last Name:TAIYARI
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 1:2028 HWY 121
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2391
Mailing Address - Country:US
Mailing Address - Phone:972-837-2929
Mailing Address - Fax:972-837-2920
Practice Address - Street 1:2028 HWY 121,
Practice Address - Street 2:300
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2391
Practice Address - Country:US
Practice Address - Phone:972-837-2929
Practice Address - Fax:972-837-2920
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice