Provider Demographics
NPI:1023874112
Name:MYRDHAP IN-HOME DENTAL HYGIENE PRACTICE OF MAHNAZ TAYARANI RDHAP
Entity type:Organization
Organization Name:MYRDHAP IN-HOME DENTAL HYGIENE PRACTICE OF MAHNAZ TAYARANI RDHAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYARANI BABAI
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:415-686-9394
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94942-0003
Mailing Address - Country:US
Mailing Address - Phone:415-686-9394
Mailing Address - Fax:
Practice Address - Street 1:1220 SHELTER BAY AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3020
Practice Address - Country:US
Practice Address - Phone:415-686-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health