Provider Demographics
NPI:1821249509
Name:ASADOLLAHI-ALIDADI, FERYAL (DDS)
Entity type:Individual
Prefix:DR
First Name:FERYAL
Middle Name:
Last Name:ASADOLLAHI-ALIDADI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:FERYAL
Other - Middle Name:
Other - Last Name:ALIDADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:430 WESTCHESTER AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2843
Mailing Address - Country:US
Mailing Address - Phone:914-289-0672
Mailing Address - Fax:914-499-0266
Practice Address - Street 1:430 WESTCHESTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-2843
Practice Address - Country:US
Practice Address - Phone:914-289-0672
Practice Address - Fax:914-499-0266
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0444291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice