Amir Reza Ardalan in Port St Lucie - Pediatric Dentistry
Amir Reza Ardalan - NPI 1093873820
Amir Reza Ardalan is a Pediatric Dentistry in Port St Lucie, Florida. Amir Reza Ardalan practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Amir Reza Ardalan is 1093873820. The last update date is 2007-07-08.
Amir Reza Ardalan's current location address is 833 Sw Grand Reserve Blvd, Port St Lucie, Florida. You can contact this provider via phone number 7728789617 and fax number 7728789617. The mailing address for Amir Reza Ardalan is 833 Sw Grand Reserve Blvd, Port St Lucie, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Amir Reza Ardalan |
|---|---|
| Address | 833 Sw Grand Reserve Blvd, Port St Lucie, Florida |
| Phone Number | 7728789617 |
| Fax Number | 7728789617 |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1093873820 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 833 Sw Grand Reserve Blvd |
|---|---|
| City | Port St Lucie |
| State | Florida (FL) |
| Post Code | 349862341 |
| Phone Number | 7728789617 |
| Fax Number | 7728789617 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | DN16127 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Post Comment/ Review Below
What is the unique identifier code issued to Amir Reza Ardalan by the Centers for Medicare & Medicaid Services (CMS)?
The Amir Reza Ardalan has been assigned the NPI (National Provider Identifier) 1093873820. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Amir Reza Ardalan is physically located?
The Amir Reza Ardalan is physically situated at the following address: 833 Sw Grand Reserve Blvd, Port St Lucie, FL, 349862341.
What is the Amir Reza Ardalan's specialty and taxonomy code?
The Amir Reza Ardalan's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1093873820 to Amir Reza Ardalan?
The Amir Reza Ardalan received its 1093873820 assignment from the Centers for Medicare & Medicaid Services on 2006-12-05.
As of what date were the details related to Amir Reza Ardalan most recently updated or revised?
The information pertaining to Amir Reza Ardalan, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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