DR. BOSHRA SOPHIA IRAVANI D.D.S. NPI 1487033619

NPI Information

NPI: 1487033619
Provider Name: DR. BOSHRA SOPHIA IRAVANI, D.D.S.
Classification: Dentist - 1223D0004X
Entity Type: Individual

Specialization: Dentist Anesthesiologist

Address:
1400 PELHAM PKWY S
BRONX, NY
ZIP 10461
Phone: (212) 844-6578
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DR. Boshra Sophia Iravani, D.D.S. is a dentist anesthesiologist dentist in Bronx, NY. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. DR. Boshra Sophia Iravani, D.D.S. NPI is 1487033619. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1400 PELHAM PKWY S
BRONX, NY
ZIP 10461-138
Phone: (212) 844-6578

The enumeration date for this NPI number is 5/20/2015 and was last updated on 9/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	1223D0004X	Dentist	Dentist Anesthesiologist	GA1968	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MK97647D	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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