Provider Demographics
NPI:1851822928
Name:ALLURE SMILE DENTISTRY PLLC
Entity Type:Organization
Organization Name:ALLURE SMILE DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARINAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TAZEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-405-9437
Mailing Address - Street 1:16 HELEN LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1827
Mailing Address - Country:US
Mailing Address - Phone:917-405-9437
Mailing Address - Fax:
Practice Address - Street 1:16 HELEN LN
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-1827
Practice Address - Country:US
Practice Address - Phone:917-405-9437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty