Individual provider Active NPI

Solomon Davidovich Borukhov, D.D.S

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1730708348
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061907 Issued in NY
Practice address
14305 41St Ave Apt 1I
Flushing, NY 11355-1801
Phone
(718) 359-3555
Fax
(718) 321-0531
NPI assigned
Apr 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 061907 NY Primary

Addresses

Primary practice location

14305 41St Ave Apt 1I
Flushing, NY 11355-1801

Mailing address

7925 150TH St Apt A2
Flushing, NY 11367-3801
Phone (718) 964-3463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
061907NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Solomon Dental PLLC General Practice CurrentSince Aug 4, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1730708348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 150TH ST APT A2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673801",
            "telephone_number": "718-964-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14305 41ST AVE APT 1I",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551801",
            "telephone_number": "718-359-3555",
            "fax_number": "718-321-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORUKHOV",
        "first_name": "SOLOMON",
        "middle_name": "DAVIDOVICH",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.