82ND Dental PLLC
Organization Active NPI General Practice Dentistry · Jackson Heights, NY
NPI 1205086147 · NPPES record last updated Sep 29, 2008
Key facts
- NPI
- 1205086147
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 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
- Organization subpart
- No
Authorized official
- Name
- Mr. Faramarz Khalili, DDS
- Title
- Primary Provider
- Phone
- (718) 476-5555
National Provider Directory
Locations
8201 Roosevelt Ave
#2
Jackson Heights, NY 11372
Phone (718) 476-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
8201 Roosevelt Ave
2ND Floor
Jackson Heights, NY 11372-7034
Mailing address
8201 Roosevelt Ave
2ND Floor
Jackson Heights, NY 11372-7034
Phone (718) 476-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01804719 | Medicaid | NY |
Other providers in Jackson Heights, NY
- 63Rd Drive RX, Inc.
- 75TH Street Medical PC
- 77 Dental PC
- 77 Pharmacy Inc
- 77 Pharmacy Inc
- 84 Street Medical PC
- 90-15 Roosevelt Pharmacy Corp
- 9301 Health Medical Corner PC
- 9317 Medical Office PC
- A1 Medicine P.C.
All providers in Jackson Heights, NY · General Practice Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.