Provider Demographics
NPI:1922415009
Name:JOY OF SMILE DENTISTRY, PC
Entity Type:Organization
Organization Name:JOY OF SMILE DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-544-2929
Mailing Address - Street 1:7011 108TH ST
Mailing Address - Street 2:1D
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4448
Mailing Address - Country:US
Mailing Address - Phone:718-544-2929
Mailing Address - Fax:
Practice Address - Street 1:7011 108TH ST
Practice Address - Street 2:1D
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4448
Practice Address - Country:US
Practice Address - Phone:718-544-2929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0549161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty