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General NPI Number Information
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NPI Number | 1033275029
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Entity Type | Individual
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Provider Name | NESHAT REZAI D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 2844 SUMMIT ST STE 203
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City | OAKLAND
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State | CA
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Zip | 94609-3642
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Country | US
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Telephone | 510-296-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 2844 SUMMIT ST STE 203
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City | OAKLAND
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State | CA
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Zip | 94609-3642
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Country | US
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Telephone | 510-296-8080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 42087
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License Number State | CA
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