Provider Demographics
NPI:1740366095
Name:NURANI, NOOREDIN (DMD)
Entity type:Individual
Prefix:DR
First Name:NOOREDIN
Middle Name:
Last Name:NURANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 DULUTH HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5215
Mailing Address - Country:US
Mailing Address - Phone:770-995-1957
Mailing Address - Fax:
Practice Address - Street 1:420 DACULA RD
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-2128
Practice Address - Country:US
Practice Address - Phone:770-277-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10916122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist