Aqua Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

052355 Issued in NY

Legal business name

AQUA DENTAL PC

Practice address

1283 Arsenal St
Watertown, NY 13601-2252

Phone

(315) 788-7888

Fax

(315) 788-7833

NPI assigned

Mar 25, 2008

Last updated

Mar 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rubina Khatoon, DDS

Title

Owner

Phone

(315) 788-7888

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1073785556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012252",
            "telephone_number": "315-788-7888",
            "fax_number": "315-788-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012252",
            "telephone_number": "315-788-7888",
            "fax_number": "315-788-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUA DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "KHATOON",
        "authorized_official_first_name": "RUBINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-788-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02698960",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1772007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Leanne Anderson
• Jennifer Lee Andrews, DPT
• Angel's Inn
• Dawn M Angello, LPN
• David H Antecol, MD
• John Arber, MD
• Lilia Arellano, PRS/PSR
• Ariana Brooks-James, MD, LLC
• Erin Helen Arndt, PT
• Florence Arnold, MD

• General Practice Dentistry in Watertown, NY
• Providers in Watertown, 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 Mar 25, 2008; 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.