Provider Demographics
NPI:1346703600
Name:AKHLAGHI, LAILA (BDS, BSC)
Entity Type:Individual
Prefix:DR
First Name:LAILA
Middle Name:
Last Name:AKHLAGHI
Suffix:
Gender:F
Credentials:BDS, BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLUMBIA SCHOOL OD DENTAL MEDICINE
Mailing Address - Street 2:622 W 168TH STREET
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA SCHOOL OF DENTISTRY
Practice Address - Street 2:630 W 168TH ST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3725
Practice Address - Country:US
Practice Address - Phone:212-305-4552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000098122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist