Derakhshandeh, Tara
Derakhshandeh, Tara is an individual health care provider with primary practice located at 3590 Bayside Lakes Blvd Se , Palm Bay FL 32909. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Derakhshandeh, Tara can be contacted via phone (321) 984-0044.Contact Information
Primary practice address
3590 Bayside Lakes Blvd Se
Palm Bay FL 32909
Phone: (321) 984-0044
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN23654 | Florida |
Profile Details
| NPI number | 1609353713 |
|---|---|
| LBN Legal business name | Derakhshandeh, Tara |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2018 |
| Last updated | Aug 2nd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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