Provider Demographics
NPI:1366862179
Name:IRANI ROHANI, MAHZARINE
Entity Type:Individual
Prefix:
First Name:MAHZARINE
Middle Name:
Last Name:IRANI ROHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 SOUTH EASTERN AVENUE
Mailing Address - Street 2:SUITE E8
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-233-1222
Mailing Address - Fax:702-233-1250
Practice Address - Street 1:4161 S EASTERN AVE STE E8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5425
Practice Address - Country:US
Practice Address - Phone:702-233-1222
Practice Address - Fax:702-233-1250
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NV6667122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program