1902601719 NPI number — INESSA MURDAKHAYEVA DENTAL P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902601719 NPI number — INESSA MURDAKHAYEVA DENTAL P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INESSA MURDAKHAYEVA DENTAL P.C.
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:
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:
1902601719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 HOWE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODMERE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11598-1310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-299-2423
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1455 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEWLETT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11557-1426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-226-9160
Provider Business Practice Location Address Fax Number:
516-226-9162
Provider Enumeration Date:
02/17/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MURDAKHAYEVA
Authorized Official First Name:
INESSA
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
516-226-9160

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)





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