Provider Demographics
NPI:1528713534
Name:NIMA MASHHOON, DMD, MS INC
Entity type:Organization
Organization Name:NIMA MASHHOON, DMD, MS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHHOON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:805-934-4000
Mailing Address - Street 1:2151 S COLLEGE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1304
Mailing Address - Country:US
Mailing Address - Phone:805-934-4000
Mailing Address - Fax:805-803-1999
Practice Address - Street 1:2151 S COLLEGE DR STE 103
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1304
Practice Address - Country:US
Practice Address - Phone:805-934-4000
Practice Address - Fax:805-803-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care