Roosevelt 26 Dentistry P.C.

LBN: Roosevelt 26 Dentistry P.C.
Roosevelt 26 Dentistry P.C. is an health care organization with primary practice located at 103-10 Roosevelt Avenue, 2Nd Flr , Corona NY 11368. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Roosevelt 26 Dentistry P.C. can be contacted via phone (718) 779-2626, or through Khalili, Faramarz via phone (718) 779-2626.

Contact Information

Primary practice address
103-10 Roosevelt Avenue, 2Nd Flr Corona NY 11368
Phone: (718) 779-2626
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Khalili, Faramarz
Phone: (718) 779-2626

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X

Profile Details

NPI number 1114237518
LBN Legal business name Roosevelt 26 Dentistry P.C.
DBA Doing business as
Authorized official Khalili, Faramarz
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2010
Last updated Oct 19th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114237518 NPPES
New York MEDICAID 01804719

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