MEDICARE: MARYAM SINA

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	1223P0221X	Pediatric Dentistry	S6-21	NV

General Provider Information

NPI Number	:	1932531639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYAM SINA

Provider Business Mailing Address
First Line	:	2551 N GREEN VALLEY PKWY
Second Line	:	SUITE 400A
City	:	HENDERSON
State	:	NV
Zip	:	89014-0272
Country	:	US
Telephone Number	:	702-458-6684
Fax Number	:	702-450-9498

Provider Business Practice Location Address
First Line	:	2551 N GREEN VALLEY PKWY
Second Line	:	SUITE 400A
City	:	HENDERSON
State	:	NV
Zip	:	89014-0272
Country	:	US
Telephone Number	:	702-458-6684
Fax Number	:	702-450-9498

Authorized Official
Title or Position	:	OWNER
Name	:	MARYAM SINA
Credential	:	D.D.S.
Telephone Number	:	702-458-6684

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	08/05/2013

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Directions to “MARYAM SINA ” Practice Location

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