Organization Active NPI

Golden Dental Care P.C

  • General Practice Dentistry
  • Woodside, NY
National Provider Identifier
1487893780
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GOLDEN DENTAL CARE P.C
Practice address
5420 31St Ave
Woodside, NY 11377-1610
Phone
(917) 659-9222
Fax
(718) 433-9106
NPI assigned
Feb 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Marina U ShimunyNPI 1255469466
Title
DDS
Phone
(718) 433-9126

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5420 31St Ave
Woodside, NY 11377-1610

Mailing address

5420 31St Ave
Woodside, NY 11377-1610
Phone (718) 433-9126

Other identifiers 1

IdentifierTypeStateIssuer
02620597MedicaidNY

National Provider Directory

National Provider Directory

Locations

158 Gardiners Ave
Levittown, NY 11756

5420 31st Ave
Woodside, NY 11377
Phone (718) 433-9126

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": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1487893780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 31ST AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771610",
            "telephone_number": "718-433-9126",
            "fax_number": "718-433-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 31ST AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113771610",
            "telephone_number": "917-659-9222",
            "fax_number": "718-433-9106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN DENTAL CARE P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "SHIMUNY",
        "authorized_official_first_name": "MARINA",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "718-433-9126"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02620597",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.