Healthcare Provider Details

I. General information

NPI: 1144993452
Provider Name (Legal Business Name): RIA HOSSAIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37-18 76ST
JACKSON HEIGHTS NY
11372
US

IV. Provider business mailing address

37-18 76ST
JACKSON HEIGHTS NY
11372
US

V. Phone/Fax

Practice location:
  • Phone: 917-780-8959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number062951
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: