Healthcare Provider Details

I. General information

NPI: 1306008271
Provider Name (Legal Business Name): PARAMITA ROY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 BLUE THORN DR
APEX NC
27539-9106
US

IV. Provider business mailing address

804 BLUE THORN DR
APEX NC
27539-9106
US

V. Phone/Fax

Practice location:
  • Phone: 201-696-7859
  • Fax:
Mailing address:
  • Phone: 201-696-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number59866
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number054886
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: