Provider Demographics
NPI:1902929797
Name:TEHRANI, SASHA (DDS)
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:TEHRANI
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 1:586 PRESIDENT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1212
Mailing Address - Country:US
Mailing Address - Phone:718-398-6300
Mailing Address - Fax:718-398-6310
Practice Address - Street 1:586 PRESIDENT ST
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1212
Practice Address - Country:US
Practice Address - Phone:718-398-6300
Practice Address - Fax:718-398-6310
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0504831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice