Healthcare Provider Details

I. General information

NPI: 1619614138
Provider Name (Legal Business Name): JOSEPH ARIEL KHAFI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17411 HORACE HARDING EXPY
FRESH MEADOWS NY
11365-1527
US

IV. Provider business mailing address

7525 153RD ST APT 605
FLUSHING NY
11367-3095
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1060
  • Fax:
Mailing address:
  • Phone: 917-847-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number063208-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: