Elham Akhlaghi

Individual provider Active NPI Periodontics · Minneapolis, MN

NPI 1861784050 · NPPES record last updated May 6, 2011

Key facts

NPI
1861784050
Entity type
Individual (NPI type 1)
Primary specialty
Periodontics 1223P0300X
License
FL26 (MN)
Practice address
515 Delaware Street
Minneapolis, MN 55455
Phone
(612) 232-7374
NPI assigned
May 6, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
FL26MNMDPeriodontist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X FL26 MN Yes

Addresses

Primary practice location

515 Delaware Street
Minneapolis, MN 55455

Mailing address

17010 40TH PL N
Plymouth, MN 55446-3357
Phone (763) 208-1574

Other providers in Minneapolis, MN

All providers in Minneapolis, MN · Periodontics in Minnesota

Sources for this page

Verify at the official NPI Registry.