Provider Demographics
NPI:1336315878
Name:RUBENSTEIN, BRIAN MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:KENNETH
Other - Middle Name:ROBERT
Other - Last Name:RUBENSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:800 WOODBURY RD STE J
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2503
Mailing Address - Country:US
Mailing Address - Phone:516-364-3388
Mailing Address - Fax:516-364-4766
Practice Address - Street 1:800 WOODBURY RD STE J
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2503
Practice Address - Country:US
Practice Address - Phone:516-364-3388
Practice Address - Fax:516-364-4766
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0433251223G0001X
NY0241771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice