Provider Demographics
NPI:1356443709
Name:ARLINGTON DENTISTRY PC
Entity Type:Organization
Organization Name:ARLINGTON DENTISTRY PC
Other - Org Name:SHANAZ IRANMANESH DMD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER DENTIST PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANAZ
Authorized Official - Middle Name:S
Authorized Official - Last Name:IRANMANESH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-461-4184
Mailing Address - Street 1:108 SANOMA DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-772-6855
Mailing Address - Fax:256-461-7892
Practice Address - Street 1:119 ARLINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758
Practice Address - Country:US
Practice Address - Phone:256-461-4184
Practice Address - Fax:256-461-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL4792122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty