Provider Demographics
NPI:1164726865
Name:J FIGUEROA DDS PC
Entity Type:Organization
Organization Name:J FIGUEROA DDS PC
Other - Org Name:PRESIDENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-665-7275
Mailing Address - Street 1:526 7TH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-4833
Mailing Address - Country:US
Mailing Address - Phone:212-221-3691
Mailing Address - Fax:212-221-3692
Practice Address - Street 1:526 7TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4833
Practice Address - Country:US
Practice Address - Phone:212-221-3691
Practice Address - Fax:212-221-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02949411Medicaid