Provider Demographics
NPI:1770711707
Name:FAHANDEJ SAADI, ASHKAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:
Last Name:FAHANDEJ SAADI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:ASHKAN
Other - Middle Name:
Other - Last Name:SAADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:125 SOUTH ST APT 300
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4441
Mailing Address - Country:US
Mailing Address - Phone:860-816-2468
Mailing Address - Fax:860-816-2468
Practice Address - Street 1:125 SOUTH ST APT 300
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4441
Practice Address - Country:US
Practice Address - Phone:860-816-2468
Practice Address - Fax:860-816-2468
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0101741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice