Queens Modern Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

050925 Issued in NY

Legal business name

QUEENS MODERN DENTAL

Practice address

21820 Hempstead Ave
Suite 2
Queens Village, NY 11429-1235

Phone

(718) 217-8700

Fax

(718) 217-8706

NPI assigned

Nov 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Lourdes Joanne Saint Paul, DDS

Title

General Dentist

Phone

(718) 217-8700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Ensworth Buchanan Jr., DDS

  • General Practice Dentistry
  • Queens Village, NY
  • NPI 1184157513
  NPD (past)

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1083991822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21820 HEMPSTEAD AVE",
            "address_2": "SUITE 2",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291235",
            "telephone_number": "718-217-8700",
            "fax_number": "718-217-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21820 HEMPSTEAD AVE",
            "address_2": "SUITE 2",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291235",
            "telephone_number": "718-217-8700",
            "fax_number": "718-217-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS MODERN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "SAINT PAUL",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "718-217-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02584774",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quality Occupational Therapy Services, PLLC
• Quantiva LLC
• Queens Corporate Foot Care, P.C.
• Queens Forever Young Social Adult Day Care, Inc
• Queens Heart Care PLLC
• Queens Multicare Psychiatric Services, PC
• Queens Parent Resource Center, Inc.
• Queens Rehab Physical Therapy PC
• Queens Village Dental Associates PC
• Queens Village Hollis Bellerose Volunteer Ambulance Corps Inc

• General Practice Dentistry in Queens Village, NY
• Providers in Queens Village, 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 Nov 8, 2011; 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.