Kermanshahchi, Mozhgan
Kermanshahchi, Mozhgan is an individual health care provider with primary practice located at 1521 Jericho Tpk , New Hyde Park NY 11040-4712. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kermanshahchi, Mozhgan can be contacted via phone (516) 616-4900.Contact Information
Primary practice address
1521 Jericho Tpk
New Hyde Park NY 11040-4712
Phone: (516) 616-4900
Fax: (516) 282-2500
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 0453901 | New York |
Profile Details
| NPI number | 1407041635 |
|---|---|
| LBN Legal business name | Kermanshahchi, Mozhgan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 11th, 2007 |
| Last updated | Sep 11th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407041635 | NPPES |
| New York | MEDICAID | 01505095 |
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