Provider Demographics
NPI:1659741668
Name:HORIZON DENTAL ARTS PC
Entity Type:Organization
Organization Name:HORIZON DENTAL ARTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:IANCU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-253-2000
Mailing Address - Street 1:1804 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4302
Mailing Address - Country:US
Mailing Address - Phone:718-253-2000
Mailing Address - Fax:718-253-0089
Practice Address - Street 1:1804 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4302
Practice Address - Country:US
Practice Address - Phone:718-253-2000
Practice Address - Fax:718-253-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057511-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03989411Medicaid