MEDICARE: DR. AJMANI PLLC

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1184269805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. AJMANI PLLC

Provider Business Mailing Address
First Line	:	4724 N MACARTHUR BLVD
Second Line	:
City	:	WARR ACRES
State	:	OK
Zip	:	73122-5012
Country	:	US
Telephone Number	:	405-495-6190
Fax Number	:

Provider Business Practice Location Address
First Line	:	4724 N MACARTHUR BLVD
Second Line	:
City	:	WARR ACRES
State	:	OK
Zip	:	73122-5012
Country	:	US
Telephone Number	:	405-495-6190
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PARUL AJMANI ELERA
Credential	:	DDS
Telephone Number	:	405-495-6190

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	11/18/2019

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