Healthcare Provider Details

I. General information

NPI: 1861898827
Provider Name (Legal Business Name): RANIA S. MEHANNA DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 BRIDGE ST
NORTH WEYMOUTH MA
02191-1124
US

IV. Provider business mailing address

312 BRIDGE ST
NORTH WEYMOUTH MA
02191-1124
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-0500
  • Fax: 781-337-0527
Mailing address:
  • Phone: 781-337-0500
  • Fax: 781-337-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number20969
License Number StateMA

VIII. Authorized Official

Name: DR. RANIA S MEHANNA
Title or Position: PC
Credential: DMD
Phone: 781-337-0500