Molavi, Sasan
Molavi, Sasan is an sole proprietor health care provider with primary practice located at 6100 Washington Ave Ste F2 , Mount Pleasant WI 53406-4000. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Molavi, Sasan can be contacted via phone (262) 999-9998.Contact Information
Primary practice address
6100 Washington Ave Ste F2
Mount Pleasant WI 53406-4000
Phone: (262) 999-9998
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 25283 | Texas |
| Dental Providers / Dentist | 122300000X | 019027961 | Illinois |
| Dental Providers / Dentist | 122300000X | DD3585 | New Mexico |
| Dental Providers / Dentist | 122300000X | 1001793 | Wisconsin |
Profile Details
| NPI number | 1467680504 |
|---|---|
| LBN Legal business name | Molavi, Sasan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2009 |
| Last updated | Jun 16th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467680504 | NPPES |
| Wisconsin | MEDICAID | 100076929 |
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