Provider Demographics
NPI:1417135609
Name:ELAHI, ELMIRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELMIRA
Middle Name:
Last Name:ELAHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GIVERNY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1006
Mailing Address - Country:US
Mailing Address - Phone:949-629-9011
Mailing Address - Fax:
Practice Address - Street 1:8 GIVERNY
Practice Address - Street 2:
Practice Address - City:NEWPORT COAST
Practice Address - State:CA
Practice Address - Zip Code:92657-1006
Practice Address - Country:US
Practice Address - Phone:949-629-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice