Provider Demographics
NPI:1053586404
Name:DAYANI, NIMA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:DAYANI
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 W 44TH STREET
Mailing Address - Street 2:SUITE 712
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-752-3636
Mailing Address - Fax:646-390-2806
Practice Address - Street 1:36 W 44TH STREET
Practice Address - Street 2:SUITE 712
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-752-3636
Practice Address - Fax:646-390-2806
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048596-11223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics