Provider Demographics
NPI:1316966799
Name:NAZAR, MEHRAN S (DDS)
Entity type:Individual
Prefix:DR
First Name:MEHRAN
Middle Name:S
Last Name:NAZAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 BOLLINGER RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3068
Mailing Address - Country:US
Mailing Address - Phone:408-446-3200
Mailing Address - Fax:
Practice Address - Street 1:6160 BOLLINGER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-3068
Practice Address - Country:US
Practice Address - Phone:408-446-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice