Provider Demographics
NPI:1962699876
Name:WALID J DEHNI, D.M.D., PC
Entity type:Organization
Organization Name:WALID J DEHNI, D.M.D., PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALID
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEHNI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-246-2211
Mailing Address - Street 1:500 SALEH ST BLD A
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2600
Mailing Address - Country:US
Mailing Address - Phone:781-246-2211
Mailing Address - Fax:781-246-5566
Practice Address - Street 1:500 SALEH ST BLD A
Practice Address - Street 2:
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-2600
Practice Address - Country:US
Practice Address - Phone:781-246-2211
Practice Address - Fax:781-246-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA185541223P0221X
MA141041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty