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General NPI Number Information
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NPI Number | 1245055466
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Entity Type | Organization
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Legal Business Name | ROOT WORKS DENTISTRY PLLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 8703 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2037
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Country | US
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Telephone | 718-849-5900
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Fax | 347-783-1714
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Provider Business Mailing Address
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Address Line | 8703 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2037
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Country | US
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Telephone | 718-849-5900
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Fax | 347-783-1714
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Authorized Official
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Title or Position | DDS
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Name | HUMIRA KHAN
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Credential | DR.
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Telephone | 718-849-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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