Provider Demographics
NPI:1750453304
Name:VELILLA, VANESSA QUREISHI (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:QUREISHI
Last Name:VELILLA
Suffix:
Gender:F
Credentials:DDS, MS
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Mailing Address - Street 1:121 W 92ND ST
Mailing Address - Street 2:APT. GF
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7576
Mailing Address - Country:US
Mailing Address - Phone:212-666-1296
Mailing Address - Fax:
Practice Address - Street 1:195 S MAPLE AVE
Practice Address - Street 2:PEDIATRIC DENTAL ASSOCIATES
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-5142
Practice Address - Country:US
Practice Address - Phone:201-652-7020
Practice Address - Fax:201-652-1550
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ22DI022065001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry