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NPI Code Detail

MEDICARE: DR. MIKE MOHAMMADREZA ZARRINNEGAR D.D.S.

MEDICARE: DR. MIKE MOHAMMADREZA ZARRINNEGAR D.D.S.
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
1122300000XDentist050350NY
21223G0001XGeneral Practice Dentistry050350NY

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 : 1710064951
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKE MOHAMMADREZA ZARRINNEGAR D.D.S.
Provider Business Mailing Address
First Line : 1231 WEBSTER AVE
Second Line : BRONX
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 646-402-8989
Fax Number : 646-402-8988
Provider Business Practice Location Address
First Line : 1231 WEBSTER AVE
Second Line : BRONX
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 646-402-8989
Fax Number : 646-402-8988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 01/10/2020

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