Roosevelt 26 Dentistry P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROOSEVELT 26 DENTISTRY P.C.

Practice address

103-10 Roosevelt Avenue, 2ND FLR
Corona, NY 11368

Phone

(718) 779-2626

NPI assigned

Oct 19, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Faramarz Khalili

Title

Owner

Phone

(718) 779-2626

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nazma Miah, DDS

  • General Practice Dentistry
  • Corona, NY
  • NPI 1881683902
  NPD (past)
• Edward Garjarian

  • Pediatric Dentistry
  • West Chester, PA
  • NPI 1235475666
  NPD (past)

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1114237518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 ROOSEVELT AVE FL 2",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-779-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103-10 ROOSEVELT AVENUE, 2ND FLR",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-779-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT 26 DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "KHALILI",
        "authorized_official_first_name": "FARAMARZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-779-2626",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01804719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura V Rojas Mena, LCSW
• Jonathan Roman, NURSE PRACTITIONER
• Marlee Roman
• Marie Rondeau
• Roosevelt 26 Dental Group PLLC
• Roosevelt Dental Care III P.C.
• Roosevelt Orthodontics
• Stephanie Ann Klajbor Rossetti, MS, CCC-SLP
• Alissa Susan Roy, PHARM.D.
• Karla Rubio

• General Practice Dentistry in Corona, NY
• Providers in Corona, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.