Healthcare Provider Details

I. General information

NPI: 1609442870
Provider Name (Legal Business Name): MOHAMAD NOOR ALSIRAFI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 07/05/2022
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8784 MONTGOMERY RD # 101
CINCINNATI OH
45236-2126
US

IV. Provider business mailing address

8784 MONTGOMERY RD # 101
CINCINNATI OH
45236-2126
US

V. Phone/Fax

Practice location:
  • Phone: 513-271-5800
  • Fax:
Mailing address:
  • Phone: 513-271-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.026881
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: