Bellerose Dental P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

044283 Issued in NY

Legal business name

BELLEROSE DENTAL P.C.

Practice address

102-32 Jamaica Avenue
Queens, NY 11418

Phone

(718) 575-1889

NPI assigned

Sep 7, 2012

Last updated

Sep 7, 2012By 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

Iosif Uvaydov, DDS

Title

Owner

Phone

(718) 575-1889

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1336498070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72-36 112TH STREET APT.612",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-575-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102-32 JAMAICA AVENUE",
            "city": "QUEENS",
            "state": "NY",
            "postal_code": "11418",
            "telephone_number": "718-575-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEROSE DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "UVAYDOV",
        "authorized_official_first_name": "IOSIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-575-1889",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02585808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Zion Barris
• Danielle Bass
• Mary Bassett, M.D.
• Rose Nellie Bayron
• Joanquina Beaublanc
• Chinonye Benjamin
• Keisha Nerissa Benjamin, M.D.
• Norah Eugenine Benjamin, LPN
• BL Healthy Life Acupuncture P.C.
• Tiffany Marie Blanco

• Oral and Maxillofacial Surgery (Dentist) in Queens, NY
• Providers in Queens, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.