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General NPI Number Information
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NPI Number | 1043457427
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Entity Type | Individual
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Provider Name | MINDY ZAHRA MOTAHARI DMD
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Gender | Female
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 09/03/2021
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Provider Practice Location Address
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Address Line | 5855 E STILL CIR
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City | MESA
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State | AZ
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Zip | 85206-3631
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Country | US
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Telephone | 480-248-8100
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Fax | 480-248-8199
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Provider Business Mailing Address
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Address Line | 4332 E SANTA FE LN
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City | GILBERT
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State | AZ
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Zip | 85297-4901
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Country | US
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Telephone | 480-330-3769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7592
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | D07592
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License Number State | AZ
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