Healthcare Provider Details

I. General information

NPI: 1386756518
Provider Name (Legal Business Name): YASMIN RAHIMIAN PAPENFUSS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 08/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 AIRPORT PULLING ROAD
NAPLES FL
34109
US

IV. Provider business mailing address

4522 EXECUTIVE DR SUITE 101
NAPLES FL
34119-9012
US

V. Phone/Fax

Practice location:
  • Phone: 239-597-7032
  • Fax:
Mailing address:
  • Phone: 239-592-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN16823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: