Provider Demographics
NPI:1952125734
Name:MENTOR PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:MENTOR PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMAMD
Authorized Official - Middle Name:YASSER
Authorized Official - Last Name:ARMANAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-840-4551
Mailing Address - Street 1:8346 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5748
Mailing Address - Country:US
Mailing Address - Phone:440-266-5437
Mailing Address - Fax:440-974-6630
Practice Address - Street 1:8346 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5748
Practice Address - Country:US
Practice Address - Phone:440-266-5437
Practice Address - Fax:440-974-6630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty