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NPI Code Detail

MEDICARE: MARYAM SINA DDS LTD

MEDICARE: MARYAM SINA DDS LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry2946NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104879717
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARYAM SINA DDS LTD
Provider Business Mailing Address
First Line : 2551 N GREEN VALLEY PKWY
Second Line : SUITE #400A
City : HENDERSON
State : NV
Zip : 89014-0272
Country : US
Telephone Number : 702-458-6684
Fax Number : 702-450-9498
Provider Business Practice Location Address
First Line : 2551 N GREEN VALLEY PKWY
Second Line : SUITE #400A
City : HENDERSON
State : NV
Zip : 89014-0272
Country : US
Telephone Number : 702-458-6684
Fax Number : 702-450-9498
Authorized Official
Title or Position : PEDIATRIC DENTIST/PRESIDENT
Name : MARYAM SINA
Credential : DDS
Telephone Number : 702-458-6684
Provider Enumeration Date : 05/18/2006
Last Update Date : 02/25/2014

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