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Contact Information

A R ADVANCED DENTAL GROUP PC
5C MEDICAL PARK DR
POMONA, NY10970-3516
 Phone: 845-364-9400
 Fax: 845-364-0284
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for A R ADVANCED DENTAL GROUP PC

NPI Number 1235285024
LBN Legal business name A R ADVANCED DENTAL GROUP PC
Authorized official ROMAN IZMAILOV - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 01/26/2007
Last updated 06/16/2008 - About 18 years ago
Identifiers
NY Medicaid 022-05-383
NY Other 11713 DORAL LOCATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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