Provider Demographics
NPI:1003020256
Name:LALEHZARI, ARMIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARMIN
Middle Name:
Last Name:LALEHZARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 OLD COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1228
Mailing Address - Country:US
Mailing Address - Phone:516-578-3369
Mailing Address - Fax:
Practice Address - Street 1:44-02 FRANCIS LEWIS BLVD. #1C
Practice Address - Street 2:DAZZLING SMILE DENTAL GROUP
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-6546
Practice Address - Country:US
Practice Address - Phone:718-255-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051768-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02678893Medicaid