Dr. Amir Reza Ardalan
Pediatric Dentist
374 Sw Prima Vista Blvd.
Port StLucie
, Florida 34983
Dr. Amir Reza Ardalan
Pediatric Dentist
374 Sw Prima Vista Blvd.
Port StLucie
, Florida 34983
(772) 878-9617
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Amir Reza Ardalan
- 833 Sw Grand Reserve Blvd
- Port St Lucie, FL
- Zip : 34986-2341
- Fax : (772) 878-9617
- Phone : (772) 878-9617
Second Address
- Dr. Amir Reza Ardalan
- 374 Sw Prima Vista Blvd.
- Port St. Lucie, FL
- Zip : 34983
- Fax : (772) 621-4498
- Phone : (772) 344-4664
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | DN16127 | FL |
National Provider Identifier
| NPI | 1093873820 |
|---|---|
| Provider Name | Dr. Amir Reza Ardalan |
| First Address | Port St Lucie, FL 34986-2341 |
| Second Address | Port St. Lucie, FL 34983 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/12/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.