Provider Demographics
NPI:1659576726
Name:AFAM DENTAL ASSOCIATES, LLP
Entity Type:Organization
Organization Name:AFAM DENTAL ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:UVAYDOV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-485-4111
Mailing Address - Street 1:5205 CHURCH AVE
Mailing Address - Street 2:2ND FLOOR, DENTAL SUITE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3513
Mailing Address - Country:US
Mailing Address - Phone:718-485-4111
Mailing Address - Fax:718-485-4449
Practice Address - Street 1:5205 CHURCH AVE
Practice Address - Street 2:2ND FLOOR, DENTAL SUITE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3513
Practice Address - Country:US
Practice Address - Phone:718-485-4111
Practice Address - Fax:718-485-4449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02585808Medicaid