Provider Demographics
NPI:1598351587
Name:UB DENTAL DENTAL SERVICES
Entity Type:Organization
Organization Name:UB DENTAL DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JANASH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-915-4504
Mailing Address - Street 1:30 CENTRAL PARK S RM 13C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1646
Mailing Address - Country:US
Mailing Address - Phone:917-915-4504
Mailing Address - Fax:
Practice Address - Street 1:527 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5236
Practice Address - Country:US
Practice Address - Phone:917-915-4504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental