Provider Demographics
NPI:1073293973
Name:GHERIANI DENTAL PLLC
Entity Type:Organization
Organization Name:GHERIANI DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:GHERIANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:443-538-5871
Mailing Address - Street 1:5475 S FORT APACHE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6410
Mailing Address - Country:US
Mailing Address - Phone:646-258-8282
Mailing Address - Fax:
Practice Address - Street 1:5475 S FORT APACHE RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6410
Practice Address - Country:US
Practice Address - Phone:702-702-1609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental