MAHDAD NASSIRI D.D.S NPI 1891136768

NPI Information

  • NPI: 1891136768
  • Provider Name: MAHDAD NASSIRI, D.D.S
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1416 PROFESSIONAL DR STE 202
    PETALUMA, CA
    ZIP 94954
  • Phone: (707) 769-1162

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NPI Details

Mahdad Nassiri, D.D.S is a periodontics dentist in Petaluma, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. Mahdad Nassiri, D.D.S NPI is 1891136768. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1416 PROFESSIONAL DR STE 202
PETALUMA, CA
ZIP 94954-108
Phone: (707) 769-1162

The NPI 1891136768 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/8/2013 and was last updated on 9/16/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodonticsDDS100289CALIFORNIAYes

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: 11/21/2025

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