Organization
ROOSEVELT 26 DENTAL GROUP PLLC
Active
Organization
ROOSEVELT 26 DENTAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARAMARZ KHALILI DDS (OWNER)
(516) 382-8000
Entity
Organization
Contact information
Practice address
10308 ROOSEVELT AVE, CORONA, NY 11368-2330
(917) 391-8000
Mailing address
10308 ROOSEVELT AVE, CORONA, NY 11368-2330
(917) 391-8000
(718) 397-8000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03060184
—
NY
Enumeration date
04/09/2019
Last updated
04/09/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up