Provider Demographics
NPI:1033252317
Name:AP DENTAL CARE, PC
Entity Type:Organization
Organization Name:AP DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POLT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-263-2040
Mailing Address - Street 1:6610 YELLOWSTONE BLVD
Mailing Address - Street 2:APT #4A
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2042
Mailing Address - Country:US
Mailing Address - Phone:718-795-5297
Mailing Address - Fax:718-263-2657
Practice Address - Street 1:6509 99TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3570
Practice Address - Country:US
Practice Address - Phone:718-263-2040
Practice Address - Fax:718-263-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0490841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02117715Medicaid
NY1205826591Medicare UPIN