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General NPI Number Information
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NPI Number | 1467339150
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Entity Type | Organization
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Legal Business Name | THE EYE DEN LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 3552 HIGHWAY 138 SE
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-4170
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Country | US
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Telephone | 770-316-8009
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Fax |
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Provider Business Mailing Address
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Address Line | 1332 PARK TRCE SE
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City | ATLANTA
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State | GA
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Zip | 30315-4444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA SALEHZADEH
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Credential | OD
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Telephone | 770-316-8009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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