Provider Demographics
NPI:1437344751
Name:ZOHUR, NIUSHA JAHROUDI (DDS)
Entity Type:Individual
Prefix:
First Name:NIUSHA
Middle Name:JAHROUDI
Last Name:ZOHUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-2231
Mailing Address - Country:US
Mailing Address - Phone:716-284-0110
Mailing Address - Fax:
Practice Address - Street 1:1705 PINE AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2231
Practice Address - Country:US
Practice Address - Phone:716-284-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053654122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1437344751Medicaid