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General NPI Number Information
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NPI Number | 1477045334
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Entity Type | Individual
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Provider Name | SASHA MOHAMMADI DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 35 BEDFORD ST STE 20
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City | LEXINGTON
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State | MA
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Zip | 02420-4440
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Country | US
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Telephone | 781-590-6703
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Fax |
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Provider Business Mailing Address
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Address Line | 4511 W 191ST ST
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City | STILWELL
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State | KS
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Zip | 66085-8889
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Country | US
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Telephone | 913-220-7495
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 05253
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 0401418626
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS044461
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN10001040
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License Number State | MA
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