Provider Demographics
NPI:1215809041
Name:PARISA TASHAKKORI, D.M.D., P.A
Entity type:Organization
Organization Name:PARISA TASHAKKORI, D.M.D., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:TASHAKKORI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-719-8500
Mailing Address - Street 1:895 STATE FARM RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-616-4895
Mailing Address - Fax:336-649-3003
Practice Address - Street 1:895 STATE FARM RD STE 204
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-616-4895
Practice Address - Fax:336-649-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty