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General NPI Number Information
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NPI Number | 1639542079
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Entity Type | Individual
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Provider Name | SONYA MOVASSAGHI D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 34194 AURORA RD #166
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City | SOLON
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State | OH
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Zip | 44139
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Country | US
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Telephone | 817-706-8654
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Fax |
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Provider Business Mailing Address
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Address Line | 34194 AURORA RD #166
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City | SOLON
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State | OH
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Zip | 44139-3801
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 100170
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.24748
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4191
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS040662
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License Number State | PA
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