Suresh K Davda, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

039139 Issued in NY

Practice address

90-24 Corona Avenue
Elmhurst, NY 11373

Phone

(718) 592-4900

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tun Lin MD., PC

  • Clinic/Center
  • Elmhurst, NY
  • NPI 1073766648
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023159290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 BUCKINGHAM DR",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088546271",
            "telephone_number": "732-699-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90-24 CORONA AVENUE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "718-592-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVDA",
        "first_name": "SURESH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00909408",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9176605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatyana Alexandra Danilov, MD
• Lady Rochelle Dante, DPT
• Rex Dante Palijo Dante, PT
• Kamil Ijaz Dar, MD
• Smita Datta
• Jasmine P. Dave, M.D.
• Mervin David, NP
• Rand A. David, M.D.
• Emely Davila Pagan, REGISTERED NURSE
• Ashe Amina Davis

• General Practice Dentistry in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.