Provider Demographics
NPI:1821114562
Name:TERMECHI, OMID (DDS)
Entity Type:Individual
Prefix:DR
First Name:OMID
Middle Name:
Last Name:TERMECHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 30TH AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2121
Mailing Address - Country:US
Mailing Address - Phone:718-956-7800
Mailing Address - Fax:718-956-7820
Practice Address - Street 1:3012 30TH AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2121
Practice Address - Country:US
Practice Address - Phone:718-956-7800
Practice Address - Fax:718-956-7820
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0485901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice