Provider Demographics
NPI:1619081056
Name:GHAFFARI, ROKHSAREH (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ROKHSAREH
Middle Name:
Last Name:GHAFFARI
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 1:223 SOUTH WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036
Mailing Address - Country:US
Mailing Address - Phone:908-862-1616
Mailing Address - Fax:908-862-4555
Practice Address - Street 1:223 SOUTH WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036
Practice Address - Country:US
Practice Address - Phone:908-862-1616
Practice Address - Fax:908-862-4555
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ196071223G0001X
NJ2201019607001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice