Provider Demographics
NPI:1730286030
Name:MARTIN J. VALINS D.D.S., P.C.
Entity Type:Organization
Organization Name:MARTIN J. VALINS D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-464-0768
Mailing Address - Street 1:21305 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3521
Mailing Address - Country:US
Mailing Address - Phone:718-464-0768
Mailing Address - Fax:718-217-5240
Practice Address - Street 1:21305 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11364-3521
Practice Address - Country:US
Practice Address - Phone:718-464-0768
Practice Address - Fax:718-217-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021257-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00288940Medicaid