Kishta-Derani, Maryam Ruby

Kishta-Derani, Maryam Ruby is an sole proprietor health care provider with primary practice located at 2815 S Pennsylvania Ave Suite 203, Lansing MI 48910-3496. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Kishta-Derani, Maryam Ruby can be contacted via phone (517) 272-4150.

Contact Information

Primary practice address
2815 S Pennsylvania Ave Suite 203 Lansing MI 48910-3496
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2901019672 Michigan

Profile Details

NPI number 1407049810
LBN Legal business name Kishta-Derani, Maryam Ruby
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2007
Last updated Aug 20th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers