Provider Demographics
NPI:1417847583
Name:DANI, MIRA
Entity type:Individual
Prefix:
First Name:MIRA
Middle Name:
Last Name:DANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 COSTA SMERALDA CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3257
Mailing Address - Country:US
Mailing Address - Phone:702-503-9099
Mailing Address - Fax:
Practice Address - Street 1:3275 COSTA SMERALDA CIR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3257
Practice Address - Country:US
Practice Address - Phone:702-503-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program