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General NPI Number Information
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NPI Number | 1396243754
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Entity Type | Organization
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Legal Business Name | AK DENTAL GROUP
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 331 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-2244
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Country | US
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Telephone | 347-933-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 13 WISTERIA DR APT 2E
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City | FORDS
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State | NJ
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Zip | 08863-1112
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Country | US
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Telephone | 347-933-1222
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. GEETA CHAINANI
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Credential |
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Telephone | 347-933-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 036727
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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