Provider Demographics
NPI:1972786036
Name:SHIRZADNIA, ALFRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:
Last Name:SHIRZADNIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 35TH ST
Mailing Address - Street 2:16TH FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2507
Mailing Address - Country:US
Mailing Address - Phone:212-689-0024
Mailing Address - Fax:212-643-9370
Practice Address - Street 1:224 W 35 STREET
Practice Address - Street 2:16 FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2529
Practice Address - Country:US
Practice Address - Phone:212-689-0024
Practice Address - Fax:212-643-9370
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist