Provider Demographics
NPI:1275806127
Name:JA ADVANCE DENTISTRY, PC
Entity Type:Organization
Organization Name:JA ADVANCE DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:I
Authorized Official - Last Name:ARONOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:917-282-9808
Mailing Address - Street 1:6514 108TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1856
Mailing Address - Country:US
Mailing Address - Phone:917-282-9808
Mailing Address - Fax:
Practice Address - Street 1:6514 108TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1856
Practice Address - Country:US
Practice Address - Phone:917-282-9808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0495161223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty