Provider Demographics
NPI:1568506780
Name:WHITEPLAINS DENTAL SERVICES,INC.
Entity Type:Organization
Organization Name:WHITEPLAINS DENTAL SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAHIMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFRESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-822-7645
Mailing Address - Street 1:1231 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-4903
Mailing Address - Country:US
Mailing Address - Phone:718-822-7645
Mailing Address - Fax:718-822-2673
Practice Address - Street 1:1231 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-4903
Practice Address - Country:US
Practice Address - Phone:718-822-7645
Practice Address - Fax:718-822-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0466961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty