MEDICARE: TALI DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	046106	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063631851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TALI DENTISTRY

Provider Business Mailing Address
First Line	:	1176 LIBERTY AVE # 2FL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3309
Country	:	US
Telephone Number	:	718-827-6001
Fax Number	:	718-277-3938

Provider Business Practice Location Address
First Line	:	1176 LIBERTY AVE # 2FL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-3309
Country	:	US
Telephone Number	:	718-827-6001
Fax Number	:	718-277-3938

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DR. FEREYDOUN KHALILI
Credential	:	INDRA
Telephone Number	:	718-827-6001

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1760473888 — JACK KASSAB DDS
Practice Location Address:

1176 LIBERTY AVE
BROOKLYN, NY
11208-3309

Practice Phone: 718-827-6001
Practice Fax:

1467672055 — KINGS DENTISTRY PC
Practice Location Address:

1176 LIBERTY AVE # 2FL
BROOKLYN, NY
11208-3309

Practice Phone: 718-827-6001
Practice Fax: 718-277-3938

1144428178 — DR. JAHANGIR IRYAMI
Practice Location Address:

1176 LIBERTY AVE , 2FL
BROOKLYN, NY
11208-3309

Practice Phone: 718-827-6001
Practice Fax: 718-277-3938

1003103896 — DR. MICHELLE H GURFINKEL DDS
Practice Location Address:

1176 LIBERTY AVE
BROOKLYN, NY
11208-3309

Practice Phone: 718-827-6001
Practice Fax:

1255290763 — FRANCES BROOKS WANNING
Practice Location Address:

164 SUYDAM ST
BROOKLYN, NY
11221-3309

Practice Phone: 718-574-6300
Practice Fax:

1437153301 — YALAMANCHI K RAO M.D.
Practice Location Address:

565 BAY RIDGE PKWY
BROOKLYN, NY
11209-3309

Practice Phone: 718-748-7551
Practice Fax: 718-921-9351

Directions to “TALI DENTISTRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.