Mandalene Mirkhah DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

D008869 Issued in AZ

Legal business name

MANDALENE MIRKHAH DDS PLLC

Practice address

717 W Glendale Ave
Phoenix, AZ 85021-8629

Phone

(602) 861-0800

NPI assigned

Jan 16, 2018

Last updated

Jan 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mandalene MirkhahNPI 1205197126

Title

Dentist

Phone

(602) 561-4092

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mandalene Jayne Mirkhah, DDS

  • Dentist
  • Phoenix, AZ
  • NPI 1205197126
  NPD (past) Authorized official
• John Maurice Goodwin, DDS

  • Dentist
  • Phoenix, AZ
  • NPI 1376746479
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516060800000",
    "number": "1841708559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 W GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218629",
            "telephone_number": "602-861-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W GLENDALE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218629",
            "telephone_number": "602-861-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANDALENE MIRKHAH DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2018-01-16",
        "status": "A",
        "authorized_official_last_name": "MIRKHAH",
        "authorized_official_first_name": "MANDALENE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "602-561-4092",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Arturo Mancilla, M.D.
• Vianney Mancilla
• Robert F Mancuso, M.D.
• Jasminder Mand, MD
• Suchita Mandair
• Cristina M. Mandanas, MD
• Victor Seguerra Mandapat, DO
• Tina Mandelman, APN CNP
• Amy Mandile, DNP-FNP-C
• Angelito Mandolado, LMT

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.