Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Payam Mirfendereski

Individual provider Oral Medicine Dentistry · NPI 1912584764

Payam Mirfendereski is an Oral Medicine Dentistry in New York, New York. Practices as a sole proprietor. Licensed in California and New York.

Licensed in
CA, NY
In the registry since
2021
Specialties on file
3

Practice location Address checks out

345 E 24th St
New York, NY 10010-4020
Phone: (212) 998-9743
Fax: (212) 995-4767
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 063834 (NY)
Oral Medicine Dentistry Taxonomy 125Q00000X · Licence 063834 (NY)
Dentist Taxonomy 122300000X · Licence 106713 (CA)

Record details

NPI number1912584764
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 26, 2021
Last updated in NPPESMay 28, 2024
Certification dateMay 28, 2024

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