1740796309 NPI number — NOUR N MASUD DDS,PLLC

Table of content: DR. MATTHEW JON RICHTER D.O. (NPI 1639464837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740796309 NPI number — NOUR N MASUD DDS,PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOUR N MASUD DDS,PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740796309
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
176 SCAMRIDGE CURV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-5213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-967-7521
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1719 SHERIDAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TONAWANDA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14223-1209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-424-0025
Provider Business Practice Location Address Fax Number:
716-424-0025
Provider Enumeration Date:
12/19/2017

Additional Information

Authorized Official

Authorized Official Last Name:
MASUD
Authorized Official First Name:
NOUR
Authorized Official Middle Name:
N
Authorized Official Title or Position:
GENERAL DENTIST, OWNER
Authorized Official Telephone Number:
716-424-0025

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com