Healthcare Provider Details

I. General information

NPI: 1326901430
Provider Name (Legal Business Name): LUXURY DENTAL OF LYNBROOK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 SUNRISE HWY
LYNBROOK NY
11563-3059
US

IV. Provider business mailing address

17 MORLEY CT
ALBERTSON NY
11507-1152
US

V. Phone/Fax

Practice location:
  • Phone: 516-825-6969
  • Fax:
Mailing address:
  • Phone: 646-232-7067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FARZIN FAROKHZADEH
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 646-232-7067