Provider Demographics
NPI:1508172651
Name:RIZVI, BATOOL FATIMA (DDS)
Entity Type:Individual
Prefix:
First Name:BATOOL
Middle Name:FATIMA
Last Name:RIZVI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18230 WEXFORD TER
Mailing Address - Street 2:APT 5Y
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3141
Mailing Address - Country:US
Mailing Address - Phone:516-567-1468
Mailing Address - Fax:
Practice Address - Street 1:18230 WEXFORD TER
Practice Address - Street 2:APT 5Y
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3141
Practice Address - Country:US
Practice Address - Phone:516-567-1468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0542571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice