Provider Demographics
NPI:1306243480
Name:NASSEH, HEMASEH (DDS)
Entity type:Individual
Prefix:MS
First Name:HEMASEH
Middle Name:
Last Name:NASSEH
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 1:93-20A ROOSEVELT AVE.
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372
Mailing Address - Country:US
Mailing Address - Phone:718-899-5437
Mailing Address - Fax:718-247-5727
Practice Address - Street 1:39-05 61ST STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377
Practice Address - Country:US
Practice Address - Phone:718-899-5437
Practice Address - Fax:718-247-5727
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0575351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice