Provider Demographics
NPI:1417172610
Name:BARADARIAN, NAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:BARADARIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CLOCK TOWER LN
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1003
Mailing Address - Country:US
Mailing Address - Phone:516-484-4278
Mailing Address - Fax:516-621-9230
Practice Address - Street 1:43 CLOCK TOWER LN
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1003
Practice Address - Country:US
Practice Address - Phone:516-484-4278
Practice Address - Fax:516-621-9230
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0502151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics