Ghassemi, Bahram

Ghassemi, Bahram is an individual health care provider with primary practice located at 68 New Edgerly Rd , Boston MA 02115. He recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Ghassemi, Bahram can be contacted via phone (617) 262-5880.

Contact Information

Primary practice address
68 New Edgerly Rd Boston MA 02115
Phone: (617) 262-5880
Fax: (617) 859-8804
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 13913 Massachusetts
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 13913 Massachusetts

Profile Details

NPI number 1356351696
LBN Legal business name Ghassemi, Bahram
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Feb 19th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356351696 NPPES
Massachusetts MEDICAID 0268631
Massachusetts Other X10762
Massachusetts Other 100437

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