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Contact Information

82ND DENTAL PLLC
8201 ROOSEVELT AVE
2ND FLOOR
JACKSON HEIGHTS, NY11372-7034
 Phone: 718-476-5555
 Fax: 718-476-6666
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 82ND DENTAL PLLC

NPI # 1205086147
LBN Legal business name 82ND DENTAL PLLC
Authorized official FARAMARZ KHALILI - (PRIMARY PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/29/2008
Last updated 09/29/2008 - About 18 years ago
Identifiers
NY Medicaid 01804719
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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