Provider Demographics
NPI:1770783706
Name:MOROVATI, MEHRAN (DDS)
Entity type:Individual
Prefix:
First Name:MEHRAN
Middle Name:
Last Name:MOROVATI
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 41ST ST FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6272
Mailing Address - Country:US
Mailing Address - Phone:212-587-3000
Mailing Address - Fax:212-587-3009
Practice Address - Street 1:18 E 41ST ST FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6272
Practice Address - Country:US
Practice Address - Phone:212-587-3000
Practice Address - Fax:212-587-3009
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044375-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice