Ruben Fattakhov, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046847 Issued in NY

Practice address

105-10 62 Rd
Apt 1F
Forest Hills, NY 11375

Phone

(718) 760-8400

Fax

(718) 760-8114

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ruben'S Dental, PLLC

  • General Practice Dentistry
  • Forest Hills, NY
  • NPI 1720250558
  NPD (past) Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821147372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6282 SAUNDERS ST APT 5I",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741554",
            "telephone_number": "718-459-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105-10 62 RD",
            "address_2": "APT 1F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-760-8400",
            "fax_number": "718-760-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTAKHOV",
        "first_name": "RUBEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "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": []
}

• Yuriy Fatakhov, DDS
• Elona Fatakhova, DDS
• Rozaliya Fatakhova, DDS
• Ezro Fattakhov, DDS
• Igor Fattakhov
• Nicholas Favia, L.AC.
• Jonathan Levi Fayzakov, DDS
• Natalya Fazilova
• Enrico Fazzini, DO
• Bonnie Federman, M.D., CGC

• General Practice Dentistry in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.