Healthcare Provider Details

I. General information

NPI: 1467108290
Provider Name (Legal Business Name): YASAMAN NAHAEI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 24TH ST
NEW YORK NY
10010-4020
US

IV. Provider business mailing address

685 1ST AVE APT 7N
NEW YORK NY
10016-2325
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-9800
  • Fax:
Mailing address:
  • Phone: 917-242-9720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number064677-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: