Individual
DR. JASON ALEXANDER BASTIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4014 82ND ST, ELMHURST, NY 11373-1305
(718) 397-7777
Mailing address
114A GREENPOINT AVE, BROOKLYN, NY 11222-2202
(347) 382-6814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059967
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
06/04/2025
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