Provider Demographics
NPI:1538308473
Name:SADRI, IMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:IMAN
Middle Name:
Last Name:SADRI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 26TH ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1831
Mailing Address - Country:US
Mailing Address - Phone:916-501-0003
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE LEVY PL
Practice Address - Street 2:MT SINAI HOSPITAL
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-6728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP65030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist