NPIMap

Organization Active NPI

Lucky Dental PC

  • Dentist
  • Rego Park, NY
National Provider Identifier
1821225822
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
046043-1 Issued in NY
Legal business name
LUCKY DENTAL PC
Practice address
6555 Woodhaven Blvd
Rego Park, NY 11374-5048
Phone
(917) 834-2219
Fax
(914) 428-6537
NPI assigned
Jun 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Authorized official

Name
Dr. Aleksandr Azbel, D.D.S
Title
Owner
Phone
(917) 834-2219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 046043-1 NY Primary

Addresses

Primary practice location

6555 Woodhaven Blvd
Rego Park, NY 11374-5048

Mailing address

6555 Woodhaven Blvd
Rego Park, NY 11374-5048
Phone (917) 834-2219

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1821225822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745048",
            "telephone_number": "917-834-2219",
            "fax_number": "914-428-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745048",
            "telephone_number": "917-834-2219",
            "fax_number": "914-428-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "AZBEL",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-834-2219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046043-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.