Provider Demographics
NPI:1245443209
Name:MEHANNA, RANIA S (DMD)
Entity type:Individual
Prefix:DR
First Name:RANIA
Middle Name:S
Last Name:MEHANNA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1124
Mailing Address - Country:US
Mailing Address - Phone:781-337-0500
Mailing Address - Fax:781-337-0527
Practice Address - Street 1:312 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NORTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02191-1124
Practice Address - Country:US
Practice Address - Phone:781-337-0500
Practice Address - Fax:781-337-0527
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1245443209OtherNPI