NPIMap

Organization Active NPI

Ruben's Dental, PLLC

  • General Practice Dentistry
  • Forest Hills, NY
National Provider Identifier
1720250558
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046847 Issued in NY
Legal business name
RUBEN'S DENTAL, PLLC
Practice address
10510 62ND Rd Apt 1F
Forest Hills, NY 11375-1122
Phone
(718) 760-8400
Fax
(718) 760-8114
NPI assigned
Apr 1, 2008
Last updated
Apr 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Dr. Ruben Fattakhov, DDSNPI 1821147372
Title
Dentist
Phone
(718) 760-8400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046847 NY Primary

Addresses

Primary practice location

10510 62ND Rd Apt 1F
Forest Hills, NY 11375-1122

Mailing address

10510 62ND Rd Apt 1F
Forest Hills, NY 11375-1122
Phone (718) 760-8400

Other identifiers 1

IdentifierTypeStateIssuer
01709737MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1720250558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 62ND RD APT 1F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751122",
            "telephone_number": "718-760-8400",
            "fax_number": "718-760-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 62ND RD APT 1F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751122",
            "telephone_number": "718-760-8400",
            "fax_number": "718-760-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBEN'S DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "FATTAKHOV",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-760-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01709737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.