Provider Demographics
NPI:1023662137
Name:COOL DENTIST PLLC
Entity type:Organization
Organization Name:COOL DENTIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEET
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAINANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-727-2555
Mailing Address - Street 1:205 PORT RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1311
Mailing Address - Country:US
Mailing Address - Phone:718-727-2555
Mailing Address - Fax:
Practice Address - Street 1:205 PORT RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1311
Practice Address - Country:US
Practice Address - Phone:718-727-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty