Provider Demographics
NPI:1215529920
Name:JULIAN BASHA DMD PLLC
Entity type:Organization
Organization Name:JULIAN BASHA DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-652-6869
Mailing Address - Street 1:383 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1151
Mailing Address - Country:US
Mailing Address - Phone:617-652-6869
Mailing Address - Fax:
Practice Address - Street 1:65 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6711
Practice Address - Country:US
Practice Address - Phone:617-652-6869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty