Provider Demographics
NPI:1457538878
Name:ALYESHMERNI, PARI (DMD)
Entity Type:Individual
Prefix:DR
First Name:PARI
Middle Name:
Last Name:ALYESHMERNI
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 1:26 PINE DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2838
Mailing Address - Country:US
Mailing Address - Phone:516-487-0520
Mailing Address - Fax:
Practice Address - Street 1:448 TEMPLE HILL RD
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-5510
Practice Address - Country:US
Practice Address - Phone:516-487-0520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038090-01122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02820840Medicaid