Sassan Bassiri, DDS
Individual provider Active NPI Dentist · King, NC
NPI 1295842904 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295842904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 7705 (NC)
- Practice address
- 642 S Main St
King, NC 27021 - Phone
- (336) 983-0095
- Fax
- (336) 983-0588
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S. Bassiri DDS PA | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7705 | NC | Yes |
Addresses
Primary practice location
642 S Main St
King, NC 27021
Mailing address
PO Box 1447
642 S Main St
King, NC 27021
Phone (336) 983-0095
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89902NU | Medicaid | NC |
Other providers in King, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.