Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 0401413118 | VA |
N | 122300000X | Dentist | G3-0000488 | DE |
N | 1223G0001X | General Practice | 14851 | MD |
N | 213EG0000X | General Practice | 14851 | MD |
Y | 1223P0221X | Pediatric Dentist | G3-0000488 | DE |
NPI | 1013201987 |
---|---|
Provider Name | Dr. Lida Alimorad |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 19/09/2019 |