Provider Demographics
NPI:1558090555
Name:J.M. RASHBAUM D.M.D., P.C.
Entity Type:Organization
Organization Name:J.M. RASHBAUM D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:RASHBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-391-1385
Mailing Address - Street 1:1410 BROADWAY RM 3004
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5030
Mailing Address - Country:US
Mailing Address - Phone:212-391-1385
Mailing Address - Fax:212-391-8540
Practice Address - Street 1:1410 BROADWAY RM 3004
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5030
Practice Address - Country:US
Practice Address - Phone:212-391-1385
Practice Address - Fax:212-391-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty