<Unavail>

LBN: Diba Dastajerdi Dmd Pc
<Unavail> is an health care organization with primary practice located at 68 New Edgerly Rd , Boston MA 02115-3503. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Diba Dastajerdi Dmd Pc can be contacted via phone (617) 262-5880, or through Dastajerdi, Diba via phone (617) 262-5880.

Contact Information

Primary practice address
68 New Edgerly Rd Boston MA 02115-3503
Phone: (617) 262-5880
Fax: (617) 859-8804
Website:
Map and Directions
Authorized official contact:
Name: Dastajerdi, Diba Doctor of Dental Medicine (DMD)
Phone: (617) 262-5880

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN21835 Massachusetts

Profile Details

NPI number 1952703480
LBN Legal business name Diba Dastajerdi Dmd Pc
DBA Doing business as <Unavail>
Authorized official Dastajerdi, Diba Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 16th, 2014
Last updated Sep 16th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952703480 NPPES
Massachusetts MEDICAID 110074397A

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