Medidental Group LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MEDIDENTAL GROUP LLC

Doing business as

MediDental Care

Practice address

2246 31St St
Astoria, NY 11105-2786

Phone

(347) 283-2396

NPI assigned

Dec 26, 2018

Last updated

Apr 15, 2025By 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

Mr. Emanuel Inoyatov

Title

Ceo

Phone

(347) 283-2396

Specialties & licenses 2

Addresses

Other names 1

• MediDental Care Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Borukhova, NP

  • Family Nurse Practitioner
  • Astoria, NY
  • NPI 1952120008
  Medicare reassignment NPD
• Walid Michelen, MD

  • Internal Medicine Physician
  • New York, NY
  • NPI 1336298645
  Medicare reassignment NPD
• David Tsadyk

  • Dentist
  • Bridgeport, CT
  • NPI 1891482873
  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1518439967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2246 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052786",
            "telephone_number": "347-283-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2246 31ST ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052786",
            "telephone_number": "347-283-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIDENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "INOYATOV",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-283-2396",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediDental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MediDental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Meany
• Frantz Medard, M.D
• Medical Arts of New York, P.C.
• Medical Care for Women, PC
• Medical Services of Lenox Hill, PC
• Paulique Fanouria Medina, LMSW
• Samantha Julia Medley
• Nabil Rached Megally, M.D.
• Shikha Mehra
• Sehrish Mehreen

• Multi-Specialty Clinic/Center in Astoria, NY
• Providers in Astoria, NY by specialty
• Multi-Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.