Provider Demographics
NPI:1275239295
Name:KIDS & FAMILY DENTISTRY
Entity Type:Organization
Organization Name:KIDS & FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIDEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLESTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-597-1818
Mailing Address - Street 1:471 W MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1720
Mailing Address - Country:US
Mailing Address - Phone:973-597-1818
Mailing Address - Fax:973-597-1817
Practice Address - Street 1:471 W MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1720
Practice Address - Country:US
Practice Address - Phone:973-597-1818
Practice Address - Fax:973-597-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental