MEDICARE: NATASHA AAZAMI DDS

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	122300000X	Dentist	2901021541	MI

General Provider Information

NPI Number	:	1518352145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA AAZAMI DDS

Provider Business Mailing Address
First Line	:	5175 HERTFORD DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-3230
Country	:	US
Telephone Number	:	248-860-9915
Fax Number	:

Provider Business Practice Location Address
First Line	:	21055 E 12 MILE RD
Second Line	:
City	:	ROSEVILLE
State	:	MI
Zip	:	48066-2205
Country	:	US
Telephone Number	:	586-772-0100
Fax Number	:

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

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	03/19/2019

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