MEDICARE: DR. AZIM HIRJI 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	037714-1	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1801886742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AZIM HIRJI DDS

Provider Business Mailing Address
First Line	:	357 ELM DR
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-3010
Country	:	US
Telephone Number	:	718-585-3311
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 E 138TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10454-3002
Country	:	US
Telephone Number	:	718-585-3311
Fax Number	:

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

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	07/09/2007

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