Provider Demographics
NPI:1073745931
Name:ELAHI, MINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:ELAHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 E 56TH ST
Mailing Address - Street 2:SUITE # 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2432
Mailing Address - Country:US
Mailing Address - Phone:212-644-1011
Mailing Address - Fax:212-583-1150
Practice Address - Street 1:433 E 56TH ST
Practice Address - Street 2:SUITE # 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2432
Practice Address - Country:US
Practice Address - Phone:212-644-1011
Practice Address - Fax:212-583-1150
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0447931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry