Provider Demographics
NPI:1699259291
Name:NAJAFI, GINA LIDA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:LIDA
Last Name:NAJAFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82969
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33682-2969
Mailing Address - Country:US
Mailing Address - Phone:813-284-4517
Mailing Address - Fax:813-405-3722
Practice Address - Street 1:7814 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3220
Practice Address - Country:US
Practice Address - Phone:813-397-5300
Practice Address - Fax:813-405-3938
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN238051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice