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General NPI Number Information
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NPI Number | 1215180039
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Entity Type | Individual
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Provider Name | NAZANIN MEHRNIA DDS
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Gender | Female
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 20101 HILLSIDE AVE
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City | HOLLIS
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State | NY
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Zip | 11423-2134
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Country | US
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Telephone | 718-479-2120
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Fax |
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Provider Business Mailing Address
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Address Line | 38 MARGARET CT
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City | GREAT NECK
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State | NY
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Zip | 11024-1808
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Country | US
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Telephone | 917-804-8952
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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 | 051868
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License Number State | NY
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