Liliya Etkina DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

C50603 Issued in NY

Legal business name

LILIYA ETKINA DDS PC

Practice address

4528 21St Street
Long Island City, NY 11101

Phone

(718) 937-7722

NPI assigned

Jan 18, 2017

Organization subpart

No

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

Authorized official

Name

Liliya Etkina, DDS

Title

Dentist/Owner

Phone

(718) 937-7722

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1396281135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-28 21ST STREET",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-937-7722",
            "fax_number": "718-937-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 21ST STREET",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "11101",
            "telephone_number": "718-937-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILIYA ETKINA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "ETKINA",
        "authorized_official_first_name": "LILIYA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "718-937-7722",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "C50603",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "057328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.