NPIMap

Organization Active NPI

Lincoln Dental, P.C.

  • Dentist
  • South Ozone Park, NY
National Provider Identifier
1649259318
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047347 Issued in NY
Legal business name
LINCOLN DENTAL, P.C.
Practice address
13114 Rockaway Blvd
South Ozone Park, NY 11420-2932
Phone
(718) 322-9022
Fax
(718) 322-4220
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Dr. Mark Lorber, DDS
Title
Owner
Phone
(718) 322-9022

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 047347 NY Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 046409 NY

Addresses

Primary practice location

13114 Rockaway Blvd
South Ozone Park, NY 11420-2932

Mailing address

13114 Rockaway Blvd
South Ozone Park, NY 11420-2932
Phone (718) 322-9022

Other identifiers 2

IdentifierTypeStateIssuer
01951528MedicaidNY
01912481MedicaidNY

National Provider Directory

National Provider Directory

Locations

13114 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 322-9022

Practitioners & affiliated clinicians

Practitioners 3

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": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1649259318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13114 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-322-9022",
            "fax_number": "718-322-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13114 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114202932",
            "telephone_number": "718-322-9022",
            "fax_number": "718-322-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "LORBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-322-9022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047347",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01951528",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01912481",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.