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General NPI Number Information
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NPI Number | 1073426359
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Entity Type | Organization
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Legal Business Name | NICOLE S TASOOJI DMD LLC
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 1475 SW CHANDLER AVE STE 201
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City | BEND
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State | OR
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Zip | 97702-3240
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Country | US
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Telephone | 458-214-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 1475 SW CHANDLER AVE STE 201
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City | BEND
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State | OR
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Zip | 97702-3240
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Country | US
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Telephone | 458-214-8691
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. NICOLE SARAH TASOOJI
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Credential | DMD
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Telephone | 858-349-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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