Provider Demographics
NPI:1356485338
Name:CONCERNED DENTAL CARE, PC
Entity Type:Organization
Organization Name:CONCERNED DENTAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-696-4979
Mailing Address - Street 1:30 E 40TH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1201
Mailing Address - Country:US
Mailing Address - Phone:212-696-4979
Mailing Address - Fax:212-447-5786
Practice Address - Street 1:30 E 40TH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1201
Practice Address - Country:US
Practice Address - Phone:212-696-4979
Practice Address - Fax:212-447-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032077-1122300000X
NY031972-3122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty