Provider Demographics
NPI:1376758516
Name:VERMA, BINOD (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:BINOD
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59-04 JUNCTION BLVD
Mailing Address - Street 2:SUITE C1
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-699-8268
Mailing Address - Fax:
Practice Address - Street 1:5904 JUNCTION BLVD
Practice Address - Street 2:SUITE C1
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5156
Practice Address - Country:US
Practice Address - Phone:718-699-8268
Practice Address - Fax:718-699-8998
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00763066Medicaid