Baharak Fooladi, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

052402 Issued in NY

Practice address

8 Medical Drive
Port Jefferson Station, NY 11776

Phone

(631) 928-8585

Fax

(631) 928-8861

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coniglio Dental PC

  • Pediatric Dentistry
  • Port Jefferson Station, NY
  • NPI 1609915883

  Orthodontics and Dentofacial Orthopedics

  NPD (past)
• Suffolk Pediatric Dentistry

  • Pediatric Dentistry
  • Port Jefferson Station, NY
  • NPI 1598997900

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407995673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEDICAL DRIVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-928-8585",
            "fax_number": "631-928-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEDICAL DRIVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-928-8585",
            "fax_number": "631-928-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOLADI",
        "first_name": "BAHARAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "052402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Catherine Fiordalisi, AGNP - C
• Thomas Anthony Fiordalisi, DC
• Barbara M. Fischer, MSW, CSW, LCSW
• Heather Marie Fischetti, MS ED
• Elden Flores
• Damian Forletti, M.D.
• Meagan Forsythe
• Jeanmarie Fortunato
• Amy Foster, LMSW
• Kristina Fowler, SPECIAL EDUCATOR

• All providers in Port Jefferson Station, NY
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.