Provider Demographics
NPI:1952428666
Name:VASI, NISREEN SAIFEE (DDS)
Entity Type:Individual
Prefix:
First Name:NISREEN
Middle Name:SAIFEE
Last Name:VASI
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 1:7075 E BLACKBIRD LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4401
Mailing Address - Country:US
Mailing Address - Phone:714-281-3191
Mailing Address - Fax:
Practice Address - Street 1:14248 HAWTHORNE BL
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250
Practice Address - Country:US
Practice Address - Phone:310-978-2974
Practice Address - Fax:310-978-0451
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist