Lida Mirzai, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7592 Issued in LA

Practice address

4610 Camp St
New Orleans, LA 70115-2835

Phone

(615) 638-1989

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1386149086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 LAKESHORE RDG",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352116957",
            "telephone_number": "615-638-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 CAMP ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701152835",
            "telephone_number": "615-638-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZAI",
        "first_name": "LIDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "7592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callie Henry Mire
• Ellen Ingram Mire
• Kristina Maria Mire, MD
• Bahareh Mirian, LPC-S, ATR
• Carmen Dorina Mironovici, M.D.
• Wagma Mirzoy, MD
• Ashley Misky, DO
• Angela H Misshore, RPH
• John Mister, LCSW
• Hayley Mitchel, DO

• Oral and Maxillofacial Surgery (Dentist) in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.