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NPI Code Detail

MEDICARE: WEBSTER DENTAL PLAZA, P.C.

MEDICARE: WEBSTER DENTAL PLAZA, P.C.
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
11223G0001XGeneral Practice Dentistry60836NY
21223P0106XOral and Maxillofacial Pathology Dentistry60836NY
31223P0221XPediatric Dentistry60836NY
4122300000XDentist60836NY

General Provider Information

NPI Number : 1679651079
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBSTER DENTAL PLAZA, P.C.
Provider Business Mailing Address
First Line : 1231 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 646-402-8989
Fax Number : 646-402-8988
Provider Business Practice Location Address
First Line : 1231 WEBSTER AVE
Second Line :
City : BRONX
State : NY
Zip : 10456-3373
Country : US
Telephone Number : 646-402-8989
Fax Number : 646-402-8988
Authorized Official
Title or Position : PRESIDENT
Name : DR. MOHAMMADREZA ZARRINNEGAR
Credential : D.D.S.
Telephone Number : 646-262-0113
Provider Enumeration Date : 11/02/2006
Last Update Date : 10/17/2008

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Directions to “WEBSTER DENTAL PLAZA, P.C. ” Practice Location

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