Prabha Krishnan DDS P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

043558 Issued in NY

Legal business name

PRABHA KRISHNAN DDS P.C.

Practice address

110-45 Queens Boulevard
Suite #108
Forest Hills, NY 11375-5501

Phone

(718) 268-5777

NPI assigned

Aug 10, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Prabha Krishnan, D.D.S.

Title

President

Phone

(718) 268-5777

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1841505344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110-45 QUEENS BOULEVARD",
            "address_2": "SUITE #108",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755501",
            "telephone_number": "718-268-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-45 QUEENS BOULEVARD",
            "address_2": "SUITE #108",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755501",
            "telephone_number": "718-268-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRABHA KRISHNAN DDS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "KRISHNAN",
        "authorized_official_first_name": "PRABHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-268-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "043558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.