Mortazavi, Seyed Heshmat
Mortazavi, Seyed Heshmat is an individual health care provider with primary practice located at 516 E. Nizhoni Blvd , Gallup NM 87301-1337. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mortazavi, Seyed Heshmat can be contacted via phone (505) 722-1000.Contact Information
Primary practice address
516 E. Nizhoni Blvd
Gallup NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 722-1565
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DE00007118 | Washington |
| Dental Providers / Dentist | 122300000X | DD2342 | New Mexico |
Profile Details
| NPI number | 1902833973 |
|---|---|
| LBN Legal business name | Mortazavi, Seyed Heshmat |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Apr 11th, 2008 - about 17 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 | 1902833973 | NPPES |
| New Mexico | MEDICAID | 000A9888 | |
| New Mexico | MEDICAID | 586084 |
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