Lic Dental Associate

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NY057422-1 Issued in NY

Legal business name

LIC DENTAL ASSOCIATE

Doing business as

LIC Dental Associates

Practice address

52-02 5TH Street
Suite B
Long Island City, NY 11101

Phone

(718) 530-6539

NPI assigned

Jul 16, 2015

Organization subpart

No

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

Authorized official

Name

Ishwinder Saran, DMD

Title

Dentist, Owner

Phone

(718) 530-6539

Specialties & licenses 1

Addresses

Other names 1

• LIC Dental Associates Doing business as

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1205210556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52-02 5TH STREET",
            "address_2": "SUITE B",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-530-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52-02 5TH STREET",
            "address_2": "SUITE B",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-530-6539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIC DENTAL ASSOCIATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "SARAN",
        "authorized_official_first_name": "ISHWINDER",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "718-530-6539",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "NY057422-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIC Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Long Island City, NY
• Providers in Long Island City, 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 16, 2015; 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.