Provider Demographics
NPI:1972693166
Name:GHAHRAMANI, NASRIN M (DDS)
Entity type:Individual
Prefix:DR
First Name:NASRIN
Middle Name:M
Last Name:GHAHRAMANI
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 1:10 SIERRA GATE PLZ STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6646
Mailing Address - Country:US
Mailing Address - Phone:916-772-0215
Mailing Address - Fax:
Practice Address - Street 1:10 SIERRA GATE PLZ STE 110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6646
Practice Address - Country:US
Practice Address - Phone:916-772-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA608421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA60842OtherCALIFORNIA DENTAL LICENCE