| Radiant Star Dental Pllc | |
|
8820 169th St Jamaica NY 11432-4431 | |
| (718) 739-6961 | |
| Not Available |
| Full Name | Radiant Star Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8820 169th St, Jamaica, New York |
| Authorized Official Name and Position | Sumit Sehgal (OWNER) |
| Authorized Official Contact | 5162364415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Star Dental Pllc 16 Horseshoe Ln Levittown NY 11756-1112 Ph: () - | Radiant Star Dental Pllc 8820 169th St Jamaica NY 11432-4431 Ph: (718) 739-6961 |
| NPI Number | 1952960742 |
|---|---|
| Provider Enumeration Date | 06/06/2019 |
| Last Update Date | 06/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952960742 | NPI | - | NPPES |
| 04333620 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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