Organization
K. KEVIN NESHAT, DDS, MD, PA
Active
Other names
Nu-Image Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHASHAYAR KEVIN NESHAT DDS, MD (PRESIDENT)
(919) 841-1720
Entity
Organization
Contact information
Practice address
8305 FALLS OF NEUSE RD, SUITE 105, RALEIGH, NC 27615-3546
(919) 841-1720
(919) 841-1725
Mailing address
8305 FALLS OF NEUSE RD, SUITE 105, RALEIGH, NC 27615-3546
(919) 841-1720
(919) 841-1725
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
6503
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2428852
MEDICARE ID P10#
NC
01
—
902AF
BCBS
NC
Enumeration date
01/23/2007
Last updated
10/15/2008
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