Provider Demographics
NPI:1053882514
Name:DAIANA ATARI DMD PLLC
Entity type:Organization
Organization Name:DAIANA ATARI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-740-1705
Mailing Address - Street 1:5816 CREEDMOOR RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2310
Mailing Address - Country:US
Mailing Address - Phone:919-298-2308
Mailing Address - Fax:919-298-2309
Practice Address - Street 1:5816 CREEDMOOR RD STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2310
Practice Address - Country:US
Practice Address - Phone:919-298-2308
Practice Address - Fax:919-298-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty