MEDICARE: DR. KIREN GEHANI DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	50 052139	NY

General Provider Information

NPI Number	:	1295968816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIREN GEHANI DDS

Provider Business Mailing Address
First Line	:	3540 82ND ST
Second Line	:	1F
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-5159
Country	:	US
Telephone Number	:	718-639-0192
Fax Number	:	718-639-8122

Provider Business Practice Location Address
First Line	:	3540 82ND ST
Second Line	:	1F
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-5159
Country	:	US
Telephone Number	:	718-639-0192
Fax Number	:	718-639-8122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2009
Last Update Date	:	08/30/2009

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