Provider Demographics
NPI:1194864967
Name:MICHAEL BERNFELD D.D.S YAKOV KURILENKO D.D.S P.C.
Entity Type:Organization
Organization Name:MICHAEL BERNFELD D.D.S YAKOV KURILENKO D.D.S P.C.
Other - Org Name:HOWARD BEACH DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-323-5132
Mailing Address - Street 1:15636 CROSSBAY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15636 CROSSBAY BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2700
Practice Address - Country:US
Practice Address - Phone:718-323-5132
Practice Address - Fax:718-323-4803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048874-11223E0200X
NY0301181223G0001X
NY049375-11223P0106X
NY046470-11223P0300X
NY050693-11223P0300X
NY030118-11223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty