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General NPI Number Information
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NPI Number | 1043902257
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Entity Type | Organization
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Legal Business Name | NIOUSHA SAGHAFI, DDS, MSD, INC.
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 1411 OLIVER RD STE 330
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City | FAIRFIELD
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State | CA
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Zip | 94534-3425
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Country | US
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Telephone | 707-716-1783
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Fax |
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Provider Business Mailing Address
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Address Line | 1411 OLIVER RD STE 330
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City | FAIRFIELD
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State | CA
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Zip | 94534-3425
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Country | US
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Telephone | 707-428-3200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIOUSHA SAGHAFI
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Credential | DDS
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Telephone | 818-430-1083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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