Provider Demographics
NPI:1922386002
Name:ARYAN, MEHDI (DMD)
Entity Type:Individual
Prefix:
First Name:MEHDI
Middle Name:
Last Name:ARYAN
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 1:300 E 93RD ST
Mailing Address - Street 2:APT. 44B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-6101
Mailing Address - Country:US
Mailing Address - Phone:781-254-7302
Mailing Address - Fax:
Practice Address - Street 1:300 E 93RD ST
Practice Address - Street 2:APT. 44B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6101
Practice Address - Country:US
Practice Address - Phone:781-254-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY056258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program