Provider Demographics
NPI:1659422681
Name:OSTAD, NASER (DDS)
Entity type:Individual
Prefix:DR
First Name:NASER
Middle Name:
Last Name:OSTAD
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 1:12330 CARMEL MOUNTAIN
Mailing Address - Street 2:C4
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128
Mailing Address - Country:US
Mailing Address - Phone:858-485-0555
Mailing Address - Fax:858-451-8396
Practice Address - Street 1:12330 CARMEL MOUNTAIN RD
Practice Address - Street 2:C4
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4654
Practice Address - Country:US
Practice Address - Phone:858-485-0555
Practice Address - Fax:858-451-8396
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist