Provider Demographics
NPI:1740327675
Name:AFSHAR-MOHAJER, ROYA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROYA
Middle Name:
Last Name:AFSHAR-MOHAJER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROYA
Other - Middle Name:A
Other - Last Name:MOHAJER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7215
Mailing Address - Country:US
Mailing Address - Phone:212-983-1227
Mailing Address - Fax:212-888-3374
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 504
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7215
Practice Address - Country:US
Practice Address - Phone:212-983-1227
Practice Address - Fax:212-888-3374
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0508201223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics