NPIMap

Organization Active NPI

Queens Village Dental Associates PC

  • Dentist
  • Queens Village, NY
National Provider Identifier
1730337577
Registry record updated Oct 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
043393 Issued in NY
Legal business name
QUEENS VILLAGE DENTAL ASSOCIATES PC
Practice address
221-10 Jamaica a.
Suite 103
Queens Village, NY 11428
Phone
(718) 464-9216
Fax
(718) 464-3953
NPI assigned
Sep 5, 2008
Last updated
Oct 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2017

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

Authorized official

Name
Dr. Jonathan Adam Flax, D.M.D.NPI 1780834895
Title
Dentist / Owner
Phone
(718) 464-9216

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 043393 NY Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 043437 NY

Addresses

Primary practice location

221-10 Jamaica a.
Suite 103
Queens Village, NY 11428

Mailing address

221-10 Jamaica a.
Suite 103
Queens Village, NY 11428
Phone (718) 464-9216

National Provider Directory

National Provider Directory

Locations

22110 Jamaica Ave
Ste 103
Queens Village, NY 11428
Phone (718) 464-9216

Practitioners & affiliated clinicians

Practitioners 2

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": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507334400000",
    "number": "1730337577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221-10 JAMAICA A.",
            "address_2": "SUITE 103",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11428",
            "telephone_number": "718-464-9216",
            "fax_number": "718-464-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221-10 JAMAICA A.",
            "address_2": "SUITE 103",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11428",
            "telephone_number": "718-464-9216",
            "fax_number": "718-464-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS VILLAGE DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2017-10-07",
        "status": "A",
        "authorized_official_last_name": "FLAX",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "718-464-9216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "043393",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "043437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2017; 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.