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General NPI Number Information
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NPI Number | 1023417029
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Entity Type | Organization
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Legal Business Name | HELLOSMILE ORTHODONTICS PC
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 103-24 ROOSEVELT AVE
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City | CORONA
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State | NY
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Zip | 11368
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Country | US
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Telephone | 718-433-2304
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Fax |
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Provider Business Mailing Address
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Address Line | 93-20 ROOSEVELT AVENUE SUITE 3D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11368
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. SADI KERMANI
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Credential |
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Telephone | 415-336-7234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0571241
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License Number State | NY
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