Dynasty Dental Care, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DYNASTY DENTAL CARE, PC

Practice address

10915 Queens Blvd
Suite 1D
Forest Hills, NY 11375-5482

Phone

(718) 263-4800

NPI assigned

Jan 26, 2017

Last updated

Jan 26, 2017By 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. Alexander D Borukhov, DMD

Title

Owner

Phone

(718) 263-4800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1902343080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 QUEENS BLVD",
            "address_2": "SUITE 1D",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755482",
            "telephone_number": "718-263-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 QUEENS BLVD",
            "address_2": "SUITE 1D",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755482",
            "telephone_number": "718-263-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNASTY DENTAL CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "BORUKHOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-263-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.