1457241655 NPI number — DENTAL IMPLANTS & COSMETICS OF REGO PARK & FOREST HILLS PC

Table of content: (NPI 1457241655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457241655 NPI number — DENTAL IMPLANTS & COSMETICS OF REGO PARK & FOREST HILLS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENTAL IMPLANTS & COSMETICS OF REGO PARK & FOREST HILLS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457241655
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7050 AUSTIN ST.
Provider Second Line Business Mailing Address:
SUILE LL124A
Provider Business Mailing Address City Name:
FOREST HILLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-275-9800
Provider Business Mailing Address Fax Number:
718-275-9800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9836 QUEENS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374-4257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-637-6997
Provider Business Practice Location Address Fax Number:
718-275-9805
Provider Enumeration Date:
07/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
BENJAMIN
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST / OWNER
Authorized Official Telephone Number:
917-744-6196

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1740612597 . This is a "DDS PROVIDER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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