Provider Demographics
NPI:1477686202
Name:GHODS, APTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:APTIN
Middle Name:
Last Name:GHODS
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 1:2505 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4011
Mailing Address - Country:US
Mailing Address - Phone:718-733-6600
Mailing Address - Fax:718-295-0966
Practice Address - Street 1:2505 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-4011
Practice Address - Country:US
Practice Address - Phone:718-733-6600
Practice Address - Fax:718-295-0966
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0452461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01521833Medicaid