NPIMap

Organization Active NPI

Bell Blvd. Dental, P.C.

  • Periodontics
  • Bayside, NY
National Provider Identifier
1487869749
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
048211 Issued in NY
Legal business name
BELL BLVD. DENTAL, P.C.
Practice address
46-01 Bell Blvd
Bayside, NY 11361
Phone
(718) 281-2222
Fax
(718) 281-2822
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Jun S Song, DDS,MMSCNPI 1538372073
Title
Dentist
Phone
(718) 281-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 047747 NY
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 054688 NY
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 048211 NY Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 048958 NY

Addresses

Primary practice location

46-01 Bell Blvd
Bayside, NY 11361

Mailing address

46-01 Bell Blvd.
Bayside, NY 11361
Phone (718) 281-2222

Other names 1

  • Harvardian Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4601 Bell Blvd
Flushing, NY 11361
Phone (718) 281-2222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1487869749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-01 BELL BLVD.",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "718-281-2222",
            "fax_number": "718-281-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46-01 BELL BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "718-281-2222",
            "fax_number": "718-281-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELL BLVD. DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JUN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-281-2222",
        "authorized_official_credential": "DDS,MMSC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047747",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054688",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "048211",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "048958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvardian Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.