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NISTAR PEDIATRIC DENTISTRY PLLC NPI 1215574694


NPI Information

NPI: 1215574694
Provider Name: NISTAR PEDIATRIC DENTISTRY PLLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
76 MERRIMACK ST STE 8A
HAVERHILL, MA
ZIP 01830
Phone: (917) 892-3625
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NISTAR PEDIATRIC DENTISTRY PLLC is a pediatric dentistry dentist in Haverhill, MA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. NISTAR PEDIATRIC DENTISTRY PLLC NPI is 1215574694. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

76 MERRIMACK ST STE 8A
HAVERHILL, MA
ZIP 01830-246
Phone: (917) 892-3625

The provider's authorized official is Shahnaaz Nistar .
The authorized official title is Dentist and has the following contact phone number (917) 892-3625.

The enumeration date for this NPI number is 12/5/2019 and was last updated on 12/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11952610008MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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