Victoria Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

054434 Issued in NY

Legal business name

VICTORIA DENTAL PLLC

Practice address

3118 Steinway St
Astoria, NY 11103-3909

Phone

(718) 728-7812

NPI assigned

Mar 3, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Robert Fatakhov, DDSNPI 1538494109

Title

Dentist/Member

Phone

(917) 291-4232

Specialties & licenses 1

Addresses

Practitioners 1

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

• Robert Fatakhov, DDS

  • General Practice Dentistry
  • Astoria, NY
  • NPI 1538494109
  NPD (past) Authorized official

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1689972473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9945 65TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3118 STEINWAY ST",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111033909",
            "telephone_number": "718-728-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "FATAKHOV",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST/MEMBER",
        "authorized_official_telephone_number": "917-291-4232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "054434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Vella
• Stefania Anne Vendome, PA-C
• Verve Psychotherapy LCSW, PLLC
• Jacqueline Marie Vicente, LMSW
• Andrew Collins Vickery
• Jorinda Vide
• Stelios Viennas, MD
• Vanessa Viera
• Marika Viglis, M.ED.
• John Villa

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.