MEDICARE: DR. NAMRATA ISHAN LAHERI 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	1223G0001X	General Practice Dentistry	2901602351	MI

General Provider Information

NPI Number	:	1417776337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAMRATA ISHAN LAHERI DDS

Provider Business Mailing Address
First Line	:	3912 FORESTER BLVD
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-3052
Country	:	US
Telephone Number	:	419-819-5734
Fax Number	:

Provider Business Practice Location Address
First Line	:	3912 FORESTER BLVD
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-3052
Country	:	US
Telephone Number	:	419-819-5734
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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