Healthcare Provider Details

I. General information

NPI: 1811806078
Provider Name (Legal Business Name): ROSEDALE DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14632 243RD ST FL 1
ROSEDALE NY
11422-2447
US

IV. Provider business mailing address

14632 243RD ST FL 1 1ST FLOOR
ROSEDALE NY
11422-2447
US

V. Phone/Fax

Practice location:
  • Phone: 718-527-6200
  • Fax: 718-525-7829
Mailing address:
  • Phone: 718-527-6200
  • Fax: 718-525-7829

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. NADEEM NASEEM
Title or Position: DENTIST
Credential: DDS
Phone: 718-527-6200