Provider Demographics
NPI:1710195763
Name:PETERSON, BINA MAKHIJANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:BINA
Middle Name:MAKHIJANI
Last Name:PETERSON
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 1:255 MILTHORN CT
Mailing Address - Street 2:
Mailing Address - City:RIVA
Mailing Address - State:MD
Mailing Address - Zip Code:21140-1512
Mailing Address - Country:US
Mailing Address - Phone:410-956-3273
Mailing Address - Fax:
Practice Address - Street 1:8092 EDWIN RAYNOR BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-6833
Practice Address - Country:US
Practice Address - Phone:410-255-7878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist