# ARDESHIR TAHERI-TAFRESHI DMD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790090272
- **Authorized official:** DR. ARDESHIR TAHERI-TAFRESHI DMD (PRESIDENT)
- **Authorized official phone:** (718) 761-3200

## Contact information

- **Practice address:** 3200 VICTORY BLVD, STATEN ISLAND, NY 10314-6723
- **Practice address phone:** (718) 761-3200
- **Mailing address:** 3200 VICTORY BLVD, STATEN ISLAND, NY 10314-6723
- **Mailing address phone:** (718) 761-3200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 054824 | NY | Yes |

## Other

- **Enumeration date:** 08/09/2010
- **Last updated:** 10/27/2014