Provider Demographics
NPI:1578122354
Name:QAFLESHI, LIRIDON (DMD)
Entity Type:Individual
Prefix:DR
First Name:LIRIDON
Middle Name:
Last Name:QAFLESHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-3817
Mailing Address - Country:US
Mailing Address - Phone:812-575-0295
Mailing Address - Fax:720-777-7239
Practice Address - Street 1:1107 OHIO ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-3817
Practice Address - Country:US
Practice Address - Phone:812-575-0295
Practice Address - Fax:720-777-7239
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013558A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry