Provider Demographics
NPI:1720444797
Name:U & I DENTAL ARTS
Entity Type:Organization
Organization Name:U & I DENTAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOON
Authorized Official - Middle Name:SEUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-631-1333
Mailing Address - Street 1:4507 248TH ST
Mailing Address - Street 2:2ND FL.
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1251
Mailing Address - Country:US
Mailing Address - Phone:718-631-1333
Mailing Address - Fax:718-631-1334
Practice Address - Street 1:4507 248TH ST
Practice Address - Street 2:2ND FL.
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1251
Practice Address - Country:US
Practice Address - Phone:718-631-1333
Practice Address - Fax:718-631-1334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050790122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003006529Medicaid