Provider Demographics
NPI:1801886742
Name:HIRJI, AZIM (DDS)
Entity type:Individual
Prefix:DR
First Name:AZIM
Middle Name:
Last Name:HIRJI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 ELM DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3010
Mailing Address - Country:US
Mailing Address - Phone:718-585-3311
Mailing Address - Fax:
Practice Address - Street 1:424 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3002
Practice Address - Country:US
Practice Address - Phone:718-585-3311
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037714-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00786338Medicaid