Provider Demographics
NPI:1720005689
Name:SPIROLLARI, MIRJETA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIRJETA
Middle Name:
Last Name:SPIROLLARI
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 1:1536 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4117
Mailing Address - Country:US
Mailing Address - Phone:718-613-7375
Mailing Address - Fax:
Practice Address - Street 1:1536 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4117
Practice Address - Country:US
Practice Address - Phone:718-613-7375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist