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General NPI Number Information
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NPI Number | 1083911713
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Entity Type | Individual
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Provider Name | SASHA M BASTON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 739 PRESIDENT PL STE 210
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City | SMYRNA
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State | TN
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Zip | 37167-6846
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Country | US
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Telephone | 615-625-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 739 PRESIDENT PL STE 210
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City | SMYRNA
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State | TN
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Zip | 37167-6846
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Country | US
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Telephone | 615-625-6900
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0560651
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 11291
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License Number State | TN
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