Healthcare Provider Details

I. General information

NPI: 1861622417
Provider Name (Legal Business Name): MAHSHID ASRARI DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 07/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 S LINDSAY RD STE 106
GILBERT AZ
85297-1504
US

IV. Provider business mailing address

3303 S LINDSAY RD STE 106
GILBERT AZ
85297-1504
US

V. Phone/Fax

Practice location:
  • Phone: 480-855-8800
  • Fax: 480-855-8802
Mailing address:
  • Phone: 480-855-8800
  • Fax: 480-855-8802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD6158
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: