Active NPI
Queensboro Dental PC
- General Practice Dentistry
- Flushing, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 045477
- Legal business name
- QUEENSBORO DENTAL PC
- Practice address
- 15034 Union Tpke
Flushing, NY 11367-3928 - Phone
- (718) 380-0011
- NPI assigned
- Dec 6, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Vladimir Khesin
- Title
- DDS
- Phone
- (718) 380-0011
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 045477 | NY | Primary |
Addresses
Primary practice location
15034 Union Tpke
Flushing, NY 11367-3928
Mailing address
15034 Union Tpke
Flushing, NY 11367-3928
Phone (718) 380-0011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01512761 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Queensboro Dental PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dental Clinic/Center
- Flushing, NY
- NPI 1992978126
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Flushing, NY
- NPI 1295826600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1033278148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15034 UNION TPKE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673928",
"telephone_number": "718-380-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15034 UNION TPKE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113673928",
"telephone_number": "718-380-0011"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUEENSBORO DENTAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KHESIN",
"authorized_official_first_name": "VLADIMIR",
"authorized_official_title_or_position": "DDS",
"authorized_official_telephone_number": "718-380-0011"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "045477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01512761",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
- Queens Relationship Counseling LCSW PLLC
- Queens Surgical Center LLC
- Queens Vision Optometry PC
- Queens Wellness Physical Therapy PC (Fyzical Therapy & Balance Centers)
- Queens-Long Island Oncology & Hematology, P.C.
- Queensboro Dental PC
- Queensboro Oral Surgery Associates
- Arturo Ernesto Quesada Gomez
- Manuela Quiceno Quintero, PA
- Teresita Quijano
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.