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General NPI Number Information
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NPI Number | 1376828244
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Entity Type | Organization
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Legal Business Name | RAMTIN NASSIRI, DDS, MSD, A PROF CORP
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 1183 SOLANO AVE
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City | ALBANY
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State | CA
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Zip | 94706-1637
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Country | US
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Telephone | 510-280-5731
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Fax |
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Provider Business Mailing Address
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Address Line | 1183 SOLANO AVE
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City | ALBANY
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State | CA
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Zip | 94706-1637
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Country | US
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Telephone | 510-280-5731
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Fax |
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Authorized Official
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Title or Position | DOCTOR/PRESIDENT
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Name | DR. RAMTIN K. NASSIRI
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Credential | D.D.S., M.S.D.
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Telephone | 510-280-5731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 54020
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License Number State | CA
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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 | 54020
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License Number State | CA
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