Provider Demographics
NPI:1316011778
Name:SAEEDI, BEHNAZ (DDS)
Entity type:Individual
Prefix:
First Name:BEHNAZ
Middle Name:
Last Name:SAEEDI
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 1:102 W EL DORADO BLVD # C1
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-6516
Mailing Address - Country:US
Mailing Address - Phone:281-990-8448
Mailing Address - Fax:
Practice Address - Street 1:102 W EL DORADO BLVD # C1
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-6516
Practice Address - Country:US
Practice Address - Phone:281-990-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60190OtherDELTA DENTAL CHIP PROGRAM
TX008381OtherPMI
TXA1358544OtherUNITED CONCORDIA