Provider Demographics
NPI:1417371006
Name:BRIGHTRAY DENTAL
Entity Type:Organization
Organization Name:BRIGHTRAY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-285-2262
Mailing Address - Street 1:13917 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3303
Mailing Address - Country:US
Mailing Address - Phone:917-285-2262
Mailing Address - Fax:631-602-5555
Practice Address - Street 1:13917 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3303
Practice Address - Country:US
Practice Address - Phone:917-285-2262
Practice Address - Fax:631-602-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0568721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty