Provider Demographics
NPI:1144235359
Name:CONCERNED DENTAL CARE, PC
Entity Type:Organization
Organization Name:CONCERNED DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-529-3800
Mailing Address - Street 1:13340 131ST ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-3804
Mailing Address - Country:US
Mailing Address - Phone:718-529-3800
Mailing Address - Fax:718-529-1761
Practice Address - Street 1:13340 131ST ST
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-3804
Practice Address - Country:US
Practice Address - Phone:718-529-3800
Practice Address - Fax:718-529-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049731-1122300000X
NY046212-1122300000X
NY047637-0122300000X
NY048101-1122300000X
NY052256-1122300000X
NY044212-1122300000X
NY028790-1122300000X
NY048704-11223E0200X
NY050903-11223E0200X
NY031972-31223G0001X
NY049654-11223P0300X
NY043614-11223P0300X
NY051569-11223S0112X
NY047329-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty