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NPI Code Detail

MEDICARE: DR. SHAHNAAZ NISTAR DDS

MEDICARE: DR. SHAHNAAZ NISTAR 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
1122300000XDentist24242TX
21223P0221XPediatric DentistryDN1857456MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952610008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAHNAAZ NISTAR DDS
Provider Business Mailing Address
First Line : 45 OWENCROFT RD # 1
Second Line :
City : BOSTON
State : MA
Zip : 02124-4723
Country : US
Telephone Number : 917-892-3625
Fax Number :
Provider Business Practice Location Address
First Line : 48 AUBURN ST
Second Line :
City : AUBURN
State : MA
Zip : 01501-2438
Country : US
Telephone Number : 508-832-6278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2010
Last Update Date : 09/28/2019

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Directions to “ DR. SHAHNAAZ NISTAR DDS” Practice Location

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