Provider Demographics
NPI:1740347921
Name:ISKANDARANI, LINA N (DMD)
Entity type:Individual
Prefix:MRS
First Name:LINA
Middle Name:N
Last Name:ISKANDARANI
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 1:1113 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2354
Mailing Address - Country:US
Mailing Address - Phone:973-779-3771
Mailing Address - Fax:973-779-7796
Practice Address - Street 1:1113 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2354
Practice Address - Country:US
Practice Address - Phone:973-779-3771
Practice Address - Fax:973-779-7796
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI178001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice