Provider Demographics
NPI:1215500533
Name:NADIMI, SAHAR (DDS)
Entity type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:NADIMI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9916 KAUFMAN PL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5831
Mailing Address - Country:US
Mailing Address - Phone:214-705-4553
Mailing Address - Fax:
Practice Address - Street 1:2260 LINDA AVE STE 103
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763-2665
Practice Address - Country:US
Practice Address - Phone:432-614-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX375811223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice