G Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

043066 Issued in NY

Legal business name

G DENTAL PC

Practice address

9123 Queens Blvd
Elmhurst, NY 11373-5531

Phone

(718) 746-7714

Fax

(718) 943-3109

NPI assigned

Sep 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dmitry Gorbunov, DDS

Title

President

Phone

(718) 746-7714

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1609024231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735531",
            "telephone_number": "718-746-7714",
            "fax_number": "718-943-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735531",
            "telephone_number": "718-746-7714",
            "fax_number": "718-943-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "GORBUNOV",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-746-7714",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "043066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.