MEDICARE: JAMSHED SOLI GHARDA DMD

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	122300000X	Dentist	047315	NY

General Provider Information

NPI Number	:	1184843211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMSHED SOLI GHARDA DMD

Provider Business Mailing Address
First Line	:	6922 NANSEN STREET
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375
Country	:	US
Telephone Number	:	917-863-5674
Fax Number	:

Provider Business Practice Location Address
First Line	:	2614 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5010
Country	:	US
Telephone Number	:	718-743-6680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/12/2019

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