Provider Demographics
NPI:1235108325
Name:NASRI-CHENIJANI, SINA (MD)
Entity Type:Individual
Prefix:
First Name:SINA
Middle Name:
Last Name:NASRI-CHENIJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5130 S FORT APACHE RD STE 215
Mailing Address - Street 2:PMB 389
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1732
Mailing Address - Country:US
Mailing Address - Phone:702-804-4729
Mailing Address - Fax:702-804-4737
Practice Address - Street 1:3150 N TENAYA WAY STE 340
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0447
Practice Address - Country:US
Practice Address - Phone:702-804-4729
Practice Address - Fax:702-804-4737
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7859207YX0007X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019825Medicaid
NV002019825Medicaid
F99575Medicare UPIN