Healthcare Provider Details

I. General information

NPI: 1598685968
Provider Name (Legal Business Name): MUHAMMAD ASHRAF NAZIR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 E KARSCH BLVD
FARMINGTON MO
63640-3025
US

IV. Provider business mailing address

408 N CATTLEMAN DR APT 2308
JOPLIN MO
64801-1965
US

V. Phone/Fax

Practice location:
  • Phone: 573-637-4404
  • Fax:
Mailing address:
  • Phone: 573-637-4404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2026010575
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: