Provider Demographics
NPI:1154413177
Name:KASHANI, PAYAM ARABZADEH (DDS)
Entity type:Individual
Prefix:DR
First Name:PAYAM
Middle Name:ARABZADEH
Last Name:KASHANI
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 1:4 FRANKLIN PL
Mailing Address - Street 2:1ST FL
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1211
Mailing Address - Country:US
Mailing Address - Phone:917-715-8845
Mailing Address - Fax:
Practice Address - Street 1:4 FRANKLIN PL
Practice Address - Street 2:1ST FL
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1211
Practice Address - Country:US
Practice Address - Phone:917-715-8845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0494941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00330231Medicare ID - Type Unspecified