Provider Demographics
NPI:1053582544
Name:NAUSHIR I. LALANI DENTIST PC
Entity type:Organization
Organization Name:NAUSHIR I. LALANI DENTIST PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAUSHIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:LALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-327-8435
Mailing Address - Street 1:216 BEACH 20TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3618
Mailing Address - Country:US
Mailing Address - Phone:718-327-8435
Mailing Address - Fax:718-327-8111
Practice Address - Street 1:216 BEACH 20TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3618
Practice Address - Country:US
Practice Address - Phone:718-327-8435
Practice Address - Fax:718-327-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0333101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02866773Medicaid
NY00307846Medicaid