Provider Demographics
NPI:1427797497
Name:LASEMI, NASIM (DMD, MS)
Entity type:Individual
Prefix:
First Name:NASIM
Middle Name:
Last Name:LASEMI
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RONSON RD APT 1309
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3092
Mailing Address - Country:US
Mailing Address - Phone:217-722-7671
Mailing Address - Fax:
Practice Address - Street 1:999 PALMER AVE STE 1
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1088
Practice Address - Country:US
Practice Address - Phone:732-671-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-29
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028985001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty