Provider Demographics
NPI:1861600322
Name:MARASHI, NILOFAR
Entity type:Individual
Prefix:
First Name:NILOFAR
Middle Name:
Last Name:MARASHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 ARIZONA AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1582
Mailing Address - Country:US
Mailing Address - Phone:310-992-6409
Mailing Address - Fax:
Practice Address - Street 1:2909 ARIZONA AVE
Practice Address - Street 2:#1
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1552
Practice Address - Country:US
Practice Address - Phone:310-922-6409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice