Provider Demographics
NPI:1154523413
Name:SOHEIL SAMIEI, D.M.D., P.C.
Entity type:Organization
Organization Name:SOHEIL SAMIEI, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMIEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-281-3772
Mailing Address - Street 1:9A DR OSMAN BABSON RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1812
Mailing Address - Country:US
Mailing Address - Phone:978-281-3772
Mailing Address - Fax:
Practice Address - Street 1:9A DR OSMAN BABSON RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1812
Practice Address - Country:US
Practice Address - Phone:978-281-3772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA182531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty