Healthcare Provider Details

I. General information

NPI: 1750952016
Provider Name (Legal Business Name): TEHREEM MEHBOOB USMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9307 245TH ST APT SUITE
FLORAL PARK NY
11001-3918
US

IV. Provider business mailing address

9307 245TH ST APT SUITE
FLORAL PARK NY
11001-3918
US

V. Phone/Fax

Practice location:
  • Phone: 516-395-4743
  • Fax:
Mailing address:
  • Phone: 516-395-4743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number062755-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: