Provider Demographics
NPI:1154533149
Name:DR. FARIDA PARVEEN D.D.S., P.C.
Entity type:Organization
Organization Name:DR. FARIDA PARVEEN D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-239-8250
Mailing Address - Street 1:2002 MCGRAW AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-8009
Mailing Address - Country:US
Mailing Address - Phone:718-239-8250
Mailing Address - Fax:718-239-7659
Practice Address - Street 1:2002 MCGRAW AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-8009
Practice Address - Country:US
Practice Address - Phone:718-239-8250
Practice Address - Fax:718-239-7659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0515181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI9185369OtherDORAL
NYK208OtherDDS
NY02582676Medicaid
PA51518NYOtherDELTA DENTAL
PA51518NYOtherDELTA DENTAL
NY=========OtherHEALTHPLEX