Provider Demographics
NPI:1588821201
Name:RUBINSHTEIN, ALEX (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:RUBINSHTEIN
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 1:37 COLERIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4105
Mailing Address - Country:US
Mailing Address - Phone:718-234-3434
Mailing Address - Fax:718-234-3496
Practice Address - Street 1:1872 80TH STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214
Practice Address - Country:US
Practice Address - Phone:718-234-3434
Practice Address - Fax:718-234-3496
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01184743Medicaid