Provider Demographics
NPI:1699056978
Name:JAMAICA 18 DENTISTRY P.C.
Entity type:Organization
Organization Name:JAMAICA 18 DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHKAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASIM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-850-3000
Mailing Address - Street 1:8701 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8701 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2037
Practice Address - Country:US
Practice Address - Phone:718-850-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0549711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty