GLENDALE BOUTIQUE DENTAL - NPI 1285079962 - Clinic/Center in Glendale, NY

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.

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About Glendale Boutique Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENDALE BOUTIQUE DENTAL (NPI 1285079962) is a healthcare organization registered as a dental in Glendale, New York and active in the NPI registry since May 2013. The organization lists Yelena M Mullakandova, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1285079962

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameBOUTIQUE DENTAL

Location Address6835 MYRTLE AVEGlendale, NY 11385-7234

Mailing Address6835 Myrtle AveGlendale, NY 11385-7234 · (718) 821-0170

Phone(718) 821-0170

Organization SubpartNo

Authorized OfficialYelena M MullakandovaOwner/dentist · (917) 640-1100

Enumeration DateMay 7, 2013

Last NPPES UpdateJuly 19, 2014

✔ NPI 1285079962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

License✔ Licensed in NY · 055256

6835 MYRTLE AVE, Glendale, NY 11385

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Other Names 1

Other NameGlendale Boutique Dental

Other Identifiers 1

Medicaid03263605NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GLENDALE MEDICAL GROUP

Internal Medicine