Provider Demographics
NPI:1922259142
Name:JAMAICA 26 DENTISTRY
Entity Type:Organization
Organization Name:JAMAICA 26 DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARMARZ
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-847-5555
Mailing Address - Street 1:11707 JAMAICA AVE
Mailing Address - Street 2:1FL
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2435
Mailing Address - Country:US
Mailing Address - Phone:718-847-5555
Mailing Address - Fax:718-847-6020
Practice Address - Street 1:11707 JAMAICA AVE
Practice Address - Street 2:1FL
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2435
Practice Address - Country:US
Practice Address - Phone:718-847-5555
Practice Address - Fax:718-847-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty