Dental Pavilion PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DENTAL PAVILION PC

Practice address

3901 Main St Ste 303
Flushing, NY 11354-5434

Phone

(718) 359-7605

NPI assigned

Oct 19, 2026

Last updated

Oct 19, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Su Jin, DDSNPI 1588643696

Title

Dentist/Owner

Phone

(718) 359-7605

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Su K Jin, DDS

  • Dentist
  • Flushing, NY
  • NPI 1588643696
  NPD (past) Authorized official

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1881590560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST STE 303",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST STE 303",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545434",
            "telephone_number": "718-359-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PAVILION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "JIN",
        "authorized_official_first_name": "SU",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "718-359-7605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juliang Deng, M.D.
• Ruiting Deng
• Daphne Denis
• Susan Denn, PA
• Dennison We
• Eli Derdik, PA
• Ermias Deress
• Dermatology and Patch Testing-Queens
• Alicia Derobertis, M.D
• John P Derosa, M.D.

• Dental Clinic/Center in Flushing, NY
• Providers in Flushing, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; 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.