Provider Demographics
NPI:1154950418
Name:DR. YASMIN FARID KOCMOND P.C
Entity type:Organization
Organization Name:DR. YASMIN FARID KOCMOND P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:VANESSA
Authorized Official - Last Name:FARID
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-292-6540
Mailing Address - Street 1:2024 OAKTON ST
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1958
Mailing Address - Country:US
Mailing Address - Phone:847-292-6540
Mailing Address - Fax:
Practice Address - Street 1:2024 OAKTON ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1958
Practice Address - Country:US
Practice Address - Phone:847-292-6540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental