Organization Active NPI

Kissena Plaza Dental P.C.

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1902110562
Registry record updated Aug 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
KISSENA PLAZA DENTAL P.C.
Practice address
70-64 Kissena Blvd
1St Floor
Flushing, NY 11367
Phone
(718) 268-8888
Fax
(718) 268-8889
NPI assigned
Aug 5, 2010
Last updated
Aug 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2010

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

Authorized official

Name
Dr. Vladimir Isakov, D.D.SNPI 1285890350
Title
President
Phone
(718) 268-8888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

70-64 Kissena Blvd
1St Floor
Flushing, NY 11367

Mailing address

70-64 Kissena Blvd
1St Floor
Flushing, NY 11367
Phone (718) 268-8888

National Provider Directory

National Provider Directory

Locations

7064 Kissena Blvd
Fl 1
Flushing, NY 11367
Phone (718) 268-8888

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1902110562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70-64 KISSENA BLVD",
            "address_2": "1ST FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "718-268-8888",
            "fax_number": "718-268-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70-64 KISSENA BLVD",
            "address_2": "1ST FLOOR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "718-268-8888",
            "fax_number": "718-268-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSENA PLAZA DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "ISAKOV",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-268-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.