Dynamic Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

044929 Issued in NY

Legal business name

DYNAMIC DENTISTRY LLC

Practice address

17515 Jamaica Ave
Jamaica, NY 11432-5525

Phone

(718) 297-4100

Fax

(718) 297-4104

NPI assigned

Nov 30, 2010

Organization subpart

No

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

Authorized official

Name

Adam Lublin

Title

Co-Owner

Phone

(718) 297-4100

Specialties & licenses 5

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.

• Protima Sohan, DDS

  • General Practice Dentistry
  • Jamaica, NY
  • NPI 1497824783
  NPD (past)

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1306148127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325525",
            "telephone_number": "718-297-4100",
            "fax_number": "718-297-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17515 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325525",
            "telephone_number": "718-297-4100",
            "fax_number": "718-297-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "LUBLIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "718-297-4100"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "032158",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044929",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "051908",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "022580",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "031327",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01980661",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Dwan
• Ezra Dweck, MD
• Jacqueline Irene de Leon Dy, ANP
• Winsome Joy H. Dyer, LMSW
• Dynamic Dental World P.C.
• Dynamicity, LLC
• Emmanuil Dzhurayev Jr., PA
• Tunisha Eaddy, LMSW
• Joanne L. Eagan, LCSW
• Florence Teresa Ealy, LMSW

• General Practice Dentistry in Jamaica, NY
• Providers in Jamaica, 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 Dec 2, 2010; 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.