Queens Family Dental Office PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0465601 Issued in NY

Legal business name

QUEENS FAMILY DENTAL OFFICE PC

Practice address

9506 Roosevelt Ave
Jackson Heights, NY 11372-8029

Phone

(718) 507-9100

Fax

(718) 507-7377

NPI assigned

Mar 20, 2008

Last updated

Mar 20, 2008By 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. Patria ReynosoNPI 1538130091

Title

President

Phone

(718) 507-9100

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Patria Iris Reynoso, DDS

  • General Practice Dentistry
  • Jackson Heights, NY
  • NPI 1538130091
  NPD (past) Authorized official

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1902077670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9506 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728029",
            "telephone_number": "718-507-9100",
            "fax_number": "718-507-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9506 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728029",
            "telephone_number": "718-507-9100",
            "fax_number": "718-507-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS FAMILY DENTAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "REYNOSO",
        "authorized_official_first_name": "PATRIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-507-9100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0465601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01676782",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brickell Quarles, PH.D.
• Queens Artificial Kidney Center
• Queens Dental Sleep Medicine, LLC (Koala Center for Sleep Disorders NY-2)
• Queens Endocrinology Partners
• Queens Express Pharmacy Corp (Queens Express Pharmacy)
• Queens Hands- on Physical Therapy. P.C
• Queens Medical PC
• Queens Medical Services, P.C (Queens Medical Center)
• Queens Nephrology Associates
• Queens Obstetrics & Gynecology Services PC

• General Practice Dentistry in Jackson Heights, NY
• Providers in Jackson Heights, 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 Mar 20, 2008; 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.