Provider Demographics
NPI:1184843211
Name:GHARDA, JAMSHED SOLI (DMD)
Entity Type:Individual
Prefix:
First Name:JAMSHED
Middle Name:SOLI
Last Name:GHARDA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:GHARDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6922 NANSEN STREET
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:917-863-5674
Mailing Address - Fax:
Practice Address - Street 1:2614 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5010
Practice Address - Country:US
Practice Address - Phone:718-743-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist