Provider Demographics
NPI:1053334839
Name:MESHKATI, KATHERINE SOROYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SOROYA
Last Name:MESHKATI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 RUGBY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1838
Mailing Address - Country:US
Mailing Address - Phone:516-678-2144
Mailing Address - Fax:
Practice Address - Street 1:2110 NORTHERN BLVD
Practice Address - Street 2:SUITE #206
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3502
Practice Address - Country:US
Practice Address - Phone:516-627-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049790-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist