Individual
DR. JUSTIN SEDAGHAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
515 MADISON AVE # 28B, NEW YORK, NY 10022-5403
(516) 423-2131
Mailing address
13 CHERRY LN, KINGS POINT, NY 11024-1121
(516) 423-2131
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
001460
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
064181
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN27494
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
08/14/2025
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