Provider Demographics
NPI:1508088899
Name:RUBINCHIK, MORDEHAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORDEHAY
Middle Name:
Last Name:RUBINCHIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13-19A RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1860
Mailing Address - Country:US
Mailing Address - Phone:551-224-8080
Mailing Address - Fax:551-224-8100
Practice Address - Street 1:13-19A RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1860
Practice Address - Country:US
Practice Address - Phone:551-224-8080
Practice Address - Fax:551-224-8100
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ210471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice