Provider Demographics
NPI:1740510585
Name:MOROVATI, JAKLIN (DDS)
Entity type:Individual
Prefix:DR
First Name:JAKLIN
Middle Name:
Last Name:MOROVATI
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 1:123 E 37TH ST
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3030
Mailing Address - Country:US
Mailing Address - Phone:212-297-2567
Mailing Address - Fax:212-696-9122
Practice Address - Street 1:123 E 37TH ST
Practice Address - Street 2:SUITE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3030
Practice Address - Country:US
Practice Address - Phone:212-297-2567
Practice Address - Fax:212-696-9122
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0463061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics