Healthcare Provider Details

I. General information

NPI: 1376288829
Provider Name (Legal Business Name): RASA ERFAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WALPOLE ST
NORWOOD MA
02062-3315
US

IV. Provider business mailing address

665 WASHINGTON ST UNIT 2501
BOSTON MA
02111-1656
US

V. Phone/Fax

Practice location:
  • Phone: 781-762-7077
  • Fax:
Mailing address:
  • Phone: 646-341-7025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN1859408
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: