Provider Demographics
NPI:1942328760
Name:RAFEE, BAYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BAYAN
Middle Name:
Last Name:RAFEE
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 1:155 ROSELAND AVE #6
Mailing Address - Street 2:ESSEX DENTAL SUIT #6
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-403-3455
Mailing Address - Fax:
Practice Address - Street 1:155 ROSELAND AVE #6
Practice Address - Street 2:ESSEX DENTAL SUIT #6
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006
Practice Address - Country:US
Practice Address - Phone:973-403-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2325100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0124362Medicaid