Patchogue Orthodontics, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

38848-1 Issued in NY

Legal business name

PATCHOGUE ORTHODONTICS, PC

Practice address

240 Patchogue Yaphank Rd
East Patchogue, NY 11772-4868

Phone

(631) 447-7623

Fax

(631) 289-3363

NPI assigned

Oct 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Robert Rubin, DDS

Title

President

Phone

(631) 447-7623

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1598136145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724868",
            "telephone_number": "631-447-7623",
            "fax_number": "631-289-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724868",
            "telephone_number": "631-447-7623",
            "fax_number": "631-289-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATCHOGUE ORTHODONTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-447-7623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "38848-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01067647",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Parish, L.AC., LMT
• Gina M Parsloe, O.D.
• Louis T Pastore, MD
• Patchogue Cardiology Associates PC
• Patchogue Family Dental, PC
• Patchogue Pediatrics PC
• Bhavik Patel
• Mitul R Patel, M.D.
• Nalinikant K. Patel, M.D.
• Preeya Patel

• Dental Clinic/Center in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.