Provider Demographics
NPI:1134387467
Name:PARVEEN, FARIDA (DDS)
Entity type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:
Last Name:PARVEEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 MCGRAW AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-8009
Mailing Address - Country:US
Mailing Address - Phone:718-239-8250
Mailing Address - Fax:718-239-7659
Practice Address - Street 1:2002 MCGRAW AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-8009
Practice Address - Country:US
Practice Address - Phone:718-239-8250
Practice Address - Fax:718-239-7659
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0515181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02582676Medicaid
WI9185369OtherDORAL DENTAL