1326255068 NPI number — DR. NASSER EMAMI DMD DDS

Table of content: DR. NASSER EMAMI DMD DDS (NPI 1326255068)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326255068 NPI number — DR. NASSER EMAMI DMD DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EMAMI
Provider First Name:
NASSER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1326255068
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4100 JOHNSON RD
Provider Second Line Business Mailing Address:
STE 203
Provider Business Mailing Address City Name:
STEUBENVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43952-2372
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-264-5300
Provider Business Mailing Address Fax Number:
740-264-4548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4100 JOHNSON RD
Provider Second Line Business Practice Location Address:
STE 203
Provider Business Practice Location Address City Name:
STEUBENVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43952-2372
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-264-5300
Provider Business Practice Location Address Fax Number:
740-264-4548
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  014248 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000128896 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000070624 . This is a "MT STATE BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com