Provider Demographics
NPI:1891928040
Name:KRIKHELY, MZIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MZIA
Middle Name:
Last Name:KRIKHELY
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 1:11117A QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5553
Mailing Address - Country:US
Mailing Address - Phone:718-544-2424
Mailing Address - Fax:718-544-2428
Practice Address - Street 1:11117A QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5553
Practice Address - Country:US
Practice Address - Phone:718-544-2424
Practice Address - Fax:718-544-2428
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0416461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01262500Medicaid