82ND Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

82ND DENTAL PLLC

Practice address

8201 Roosevelt Ave
2ND Floor
Jackson Heights, NY 11372-7034

Phone

(718) 476-5555

Fax

(718) 476-6666

NPI assigned

Sep 29, 2008

Last updated

Sep 29, 2008By 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

Mr. Faramarz Khalili, DDS

Title

Primary Provider

Phone

(718) 476-5555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1205086147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 ROOSEVELT AVE",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727034",
            "telephone_number": "718-476-5555",
            "fax_number": "718-476-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 ROOSEVELT AVE",
            "address_2": "2ND FLOOR",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727034",
            "telephone_number": "718-476-5555",
            "fax_number": "718-476-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "82ND DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "KHALILI",
        "authorized_official_first_name": "FARAMARZ",
        "authorized_official_title_or_position": "PRIMARY PROVIDER",
        "authorized_official_telephone_number": "718-476-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Jackson Heights, NY
• Providers in Jackson Heights, 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 Sep 29, 2008; 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.