Provider Demographics
NPI:1992911820
Name:KHOOBEHI, NILOUFAR (DMD)
Entity type:Individual
Prefix:DR
First Name:NILOUFAR
Middle Name:
Last Name:KHOOBEHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WHITING ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3724
Mailing Address - Country:US
Mailing Address - Phone:781-749-1119
Mailing Address - Fax:
Practice Address - Street 1:210 WHITING ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3724
Practice Address - Country:US
Practice Address - Phone:781-749-1119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA202801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics