Provider Demographics
NPI:1669462594
Name:ISRANI, MINISHA ASHIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINISHA
Middle Name:ASHIN
Last Name:ISRANI
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 1:8340 BRITTON AVE
Mailing Address - Street 2:UNIT P1
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2469
Mailing Address - Country:US
Mailing Address - Phone:718-426-7511
Mailing Address - Fax:718-426-7511
Practice Address - Street 1:8340 BRITTON AVE
Practice Address - Street 2:UNIT P1
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2469
Practice Address - Country:US
Practice Address - Phone:718-426-7511
Practice Address - Fax:718-426-7511
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01759246Medicaid