G.L Dental Practice

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046122 Issued in NY

Legal business name

G.L DENTAL PRACTICE

Practice address

22117 Jamaica Ave
Queens Village, NY 11428-2015

Phone

(718) 454-4000

Fax

(718) 479-9171

NPI assigned

Jul 16, 2006

Last updated

Aug 22, 2020By 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

Dr. Babak Nahavandi, DDSNPI 1104879543

Title

Dentist

Phone

(718) 454-4000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Babak Nahavandi, DDS

  • Dentist
  • Queens Village, NY
  • NPI 1104879543
  NPD (past) Authorized official

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518984558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22117 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282015",
            "telephone_number": "718-454-4000",
            "fax_number": "718-479-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22117 JAMAICA AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114282015",
            "telephone_number": "718-454-4000",
            "fax_number": "718-479-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G.L DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAHAVANDI",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-454-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy V Fredericks, RN
• Daisy I Freire, MS. ED
• Marcela Freire
• Marlow Fuentes, RN
• G & M Business Inc (county pharmacy)
• Gailaz Home Health Care Agency and Staffing Services, Inc
• Iasha Gaines, LMSW
• Elena Borisovna Galkina, M.D.
• Joyzel Gallardo, PT
• Dominick Galluccio, RPH

• General Practice Dentistry in Queens Village, NY
• Providers in Queens Village, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.