Lil Pearls Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

056689-1 Issued in NY

Legal business name

LIL PEARLS PEDIATRIC DENTISTRY PLLC

Practice address

94-11 65TH Rd
Suite 1B
Rego Park, NY 11374

Phone

(347) 682-5688

NPI assigned

May 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Fong, D.D.S.NPI 1790076735

Title

Member

Phone

(516) 241-9760

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Fong, D.D.S.

  • Pediatric Dentistry
  • Rego Park, NY
  • NPI 1790076735
  NPD (past) Authorized official

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1669859294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-11 65TH RD",
            "address_2": "SUITE 1B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-11 65TH RD",
            "address_2": "SUITE 1B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "347-682-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIL PEARLS PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-241-9760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "056689-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03634535",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celia Liang, DO
• Nellie E. Liciaga, LCSW, M-CASAC
• Steven Lieberman, OD, FAAO, PC
• Life Medical Supply Inc.
• Lifeskills Preshool Program
• Lilia B Idanan Physician, PC
• John Lim, PHARMD.
• Pao-Chen Lin, PT, DPT
• Yiyu Lin, D.P.T
• Lincoln Medical and Mental Health Center

• Pediatric Dentistry in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.