Healthcare Provider Details

I. General information

NPI: 1568372019
Provider Name (Legal Business Name): ASTORIA KIDS DENTAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 36TH AVE APT 1DA
ASTORIA NY
11106-3111
US

IV. Provider business mailing address

2915 36TH AVE APT 1DA
ASTORIA NY
11106-3111
US

V. Phone/Fax

Practice location:
  • Phone: 646-725-5616
  • Fax:
Mailing address:
  • Phone: 646-725-5616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. NIAZ AHMED
Title or Position: DR.
Credential: DDS
Phone: 646-725-5616