Provider Demographics
NPI:1730254293
Name:JAMASI, NILOFAR MUJTABA (DMD)
Entity type:Individual
Prefix:DR
First Name:NILOFAR
Middle Name:MUJTABA
Last Name:JAMASI
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 1:118 SAGECREST DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4601
Mailing Address - Country:US
Mailing Address - Phone:407-876-9269
Mailing Address - Fax:407-876-9269
Practice Address - Street 1:3066 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1544
Practice Address - Country:US
Practice Address - Phone:407-343-9800
Practice Address - Fax:407-876-9269
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN154551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice