Provider Demographics
NPI:1912588344
Name:PANOOSIAN-HAJIABADI, NARINEH (DMD)
Entity Type:Individual
Prefix:
First Name:NARINEH
Middle Name:
Last Name:PANOOSIAN-HAJIABADI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 ASHVILLE AVE STE H
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6667
Mailing Address - Country:US
Mailing Address - Phone:919-467-0635
Mailing Address - Fax:
Practice Address - Street 1:305 ASHVILLE AVE STE H
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6667
Practice Address - Country:US
Practice Address - Phone:919-467-0635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133181223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223P0221XDental ProvidersDentistPediatric Dentistry