Provider Demographics
NPI:1427797091
Name:NICOLE KHALIFE DDS PC
Entity type:Organization
Organization Name:NICOLE KHALIFE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-770-9777
Mailing Address - Street 1:7 GRAMERCY PARK W # C1-B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1759
Mailing Address - Country:US
Mailing Address - Phone:212-777-7126
Mailing Address - Fax:
Practice Address - Street 1:7 GRAMERCY PARK W # C1-B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1759
Practice Address - Country:US
Practice Address - Phone:212-777-7126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty