Provider Demographics
NPI:1720314446
Name:SADEGHI, ARIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARIAN
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7034
Mailing Address - Country:US
Mailing Address - Phone:347-579-5159
Mailing Address - Fax:347-436-9569
Practice Address - Street 1:8201 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7034
Practice Address - Country:US
Practice Address - Phone:347-579-5159
Practice Address - Fax:347-436-9569
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0518611223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery