Provider Demographics
NPI:1306158852
Name:PRISHTINA, ARDIAN N (DMD)
Entity type:Individual
Prefix:DR
First Name:ARDIAN
Middle Name:N
Last Name:PRISHTINA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11513 S MEMORIAL PKWY
Mailing Address - Street 2:UNIT B
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-4425
Mailing Address - Country:US
Mailing Address - Phone:256-885-1941
Mailing Address - Fax:
Practice Address - Street 1:11513 S MEMORIAL PKWY
Practice Address - Street 2:UNIT B
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-4425
Practice Address - Country:US
Practice Address - Phone:256-885-1941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice