Provider Demographics
NPI:1871672758
Name:BINA, BABAK (DMD)
Entity Type:Individual
Prefix:DR
First Name:BABAK
Middle Name:
Last Name:BINA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 55TH ST
Mailing Address - Street 2:DENTAL DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2508
Mailing Address - Country:US
Mailing Address - Phone:718-630-6816
Mailing Address - Fax:718-492-5090
Practice Address - Street 1:150 55TH ST
Practice Address - Street 2:DENTAL DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2508
Practice Address - Country:US
Practice Address - Phone:718-630-6816
Practice Address - Fax:718-492-5090
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0477431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice