Blue Bay Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

055080 Issued in NY

Legal business name

BLUE BAY DENTAL, PC

Practice address

13620 38TH Ave Ste 8D
Flushing, NY 11354-4232

Phone

(718) 888-9118

Fax

(718) 888-0508

NPI assigned

Dec 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Wenxia Zhou, DDS, PHD

Title

Owner

Phone

(718) 888-9118

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1790088730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE STE 8D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544232",
            "telephone_number": "718-888-9118",
            "fax_number": "718-888-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13620 38TH AVE STE 8D",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544232",
            "telephone_number": "718-888-9118",
            "fax_number": "718-888-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE BAY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "ZHOU",
        "authorized_official_first_name": "WENXIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-888-9118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PHD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03242697",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.