Provider Demographics
NPI:1831226257
Name:SHAHVEISSI-ORYANI, MEHRZAD NANCY (DDS)
Entity type:Individual
Prefix:
First Name:MEHRZAD
Middle Name:NANCY
Last Name:SHAHVEISSI-ORYANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:ORYANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:495 ODELL AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1146
Mailing Address - Country:US
Mailing Address - Phone:914-423-0000
Mailing Address - Fax:
Practice Address - Street 1:495 ODELL AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1146
Practice Address - Country:US
Practice Address - Phone:914-423-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04176411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice