Jerome Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

046347 Issued in NY

Legal business name

JEROME DENTAL PC

Practice address

1810 Jerome Ave
2ND Floor
Brooklyn, NY 11235-3621

Phone

(718) 615-2030

Fax

(718) 615-2030

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nataliya Gubenko, DDSNPI 1265632798

Title

Executive Officer

Phone

(718) 615-2030

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.

• Nataliya Gubenko, DDS

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1265632798
  NPD (past) Authorized official

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184457600000",
    "number": "1487797338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 JEROME AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353621",
            "telephone_number": "718-615-2030",
            "fax_number": "718-615-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 JEROME AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353621",
            "telephone_number": "718-615-2030",
            "fax_number": "718-615-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-15",
        "status": "A",
        "authorized_official_last_name": "GUBENKO",
        "authorized_official_first_name": "NATALIYA",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "718-615-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "046347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01663405",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jericho Medical Care PC
• Sharon Jerido
• Yelena Jernigan
• Jerome & Milton Rosenblum Inc
• Jerome B. Leff, DPM, PC
• Jerome S. Rosenberg DDS, PC
• Jerome Street Clinic
• Eric Louis Jerome, M.D
• Jerma Jerome
• Leigh W. Jerome

• All providers in Brooklyn, NY
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2007; 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.