Provider Demographics
NPI:1598197923
Name:AMINOV, RUBEN (DDS)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:AMINOV
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 1:6310 108TH ST
Mailing Address - Street 2:APT # 5H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1355
Mailing Address - Country:US
Mailing Address - Phone:646-291-7727
Mailing Address - Fax:
Practice Address - Street 1:6310 108TH ST
Practice Address - Street 2:APT # 5H
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1355
Practice Address - Country:US
Practice Address - Phone:646-291-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056791-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist