Mahdavi, Maryam
Mahdavi, Maryam is an sole proprietor health care provider with primary practice located at 978 Rockaway Ave , Valley Stream NY 11581-2136. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is her primary health care specialty. Mahdavi, Maryam can be contacted via phone (617) 909-6118.Contact Information
Primary practice address
978 Rockaway Ave
Valley Stream NY 11581-2136
Phone: (617) 909-6118
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 060887-01 | New York |
Profile Details
| NPI number | 1851753156 |
|---|---|
| LBN Legal business name | Mahdavi, Maryam |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 25th, 2016 |
| Last updated | Oct 22nd, 2021 - about 5 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.
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