MEDICARE: NORA NAKSHABENDI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DN1857285	MA
2	1223P0221X	Pediatric Dentistry	DN27562	FL

General Provider Information

NPI Number	:	1386003879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA NAKSHABENDI DMD

Provider Business Mailing Address
First Line	:	5041 WESLEY DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1376
Country	:	US
Telephone Number	:	813-363-3555
Fax Number	:

Provider Business Practice Location Address
First Line	:	10317 CROSS CREEK BLVD STE B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2845
Country	:	US
Telephone Number	:	813-363-3555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2016
Last Update Date	:	05/14/2024

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