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General NPI Number Information
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NPI Number | 1306352026
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Entity Type | Individual
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Provider Name | MAHDIEH BEHESHTI DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 209 HARVARD ST FL 2
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City | BROOKLINE
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State | MA
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Zip | 02446-5071
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Country | US
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Telephone | 617-731-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 80 HOPE AVE APT 404
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City | WALTHAM
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State | MA
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Zip | 02453-2746
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Country | US
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Telephone | 860-837-3319
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1859671
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License Number State | MA
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