Healthcare Provider Details

I. General information

NPI: 1134346729
Provider Name (Legal Business Name): PARASTOO PARSA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N. 14TH STREET SUITE 820
SAN JOSE CA
95112
US

IV. Provider business mailing address

25 N. 14TH STREET SUITE 820
SAN JOSE CA
95112
US

V. Phone/Fax

Practice location:
  • Phone: 408-293-2337
  • Fax:
Mailing address:
  • Phone: 916-220-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number49632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: