Provider Demographics
NPI:1083769806
Name:ARMANAZI, YASSER MOHAMMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:YASSER
Middle Name:MOHAMMAD
Last Name:ARMANAZI
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 1:9179 MENTOR AVE
Mailing Address - Street 2:SIUTE # G
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6398
Mailing Address - Country:US
Mailing Address - Phone:440-266-5437
Mailing Address - Fax:440-974-6630
Practice Address - Street 1:9179 MENTOR AVE
Practice Address - Street 2:SIUTE # G
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6398
Practice Address - Country:US
Practice Address - Phone:440-266-5437
Practice Address - Fax:440-974-6630
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300216221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2412991Medicaid