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General NPI Number Information
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NPI Number | 1790307346
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Entity Type | Individual
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Provider Name | PARSA BASSERI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/16/2020
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 841 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10003-4704
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Country | US
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Telephone | 646-502-9770
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SOPHIE CT
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City | WOODCLIFF LAKE
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State | NJ
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Zip | 07677-7961
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Country | US
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Telephone | 929-777-6139
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 61779-01
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License Number State | NY
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