Provider Demographics
NPI:1912638917
Name:S BASSIRI & ASSOCIATES PA
Entity Type:Organization
Organization Name:S BASSIRI & ASSOCIATES PA
Other - Org Name:KING FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-983-0095
Mailing Address - Street 1:PO BOX 1447
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-1447
Mailing Address - Country:US
Mailing Address - Phone:336-983-0095
Mailing Address - Fax:336-983-0588
Practice Address - Street 1:226 KIRBY RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-9492
Practice Address - Country:US
Practice Address - Phone:336-983-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty