Provider Demographics
NPI:1427355510
Name:ROSHAN BAKHTIAR CUMMINS DMD PC
Entity type:Organization
Organization Name:ROSHAN BAKHTIAR CUMMINS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSHAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-421-9757
Mailing Address - Street 1:595 MADISON AVE
Mailing Address - Street 2:SUITE 2008
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-421-9757
Mailing Address - Fax:
Practice Address - Street 1:595 MADISON AVE
Practice Address - Street 2:SUITE 2008
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-421-9757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty