Provider Demographics
NPI:1508175027
Name:SHAHINYAN, GEGHANI (DDS)
Entity Type:Individual
Prefix:MRS
First Name:GEGHANI
Middle Name:
Last Name:SHAHINYAN
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 1:551 MAIN ST
Mailing Address - Street 2:APT W210
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0119
Mailing Address - Country:US
Mailing Address - Phone:646-963-1294
Mailing Address - Fax:
Practice Address - Street 1:551 MAIN ST
Practice Address - Street 2:APT W210
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0119
Practice Address - Country:US
Practice Address - Phone:646-963-1294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024457001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice