Provider Demographics
NPI:1831453182
Name:DYNAMIC DENTAL WORLD P.C.
Entity type:Organization
Organization Name:DYNAMIC DENTAL WORLD P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-739-0900
Mailing Address - Street 1:8961 165TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5143
Mailing Address - Country:US
Mailing Address - Phone:718-657-5656
Mailing Address - Fax:718-739-0900
Practice Address - Street 1:8961 165TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5143
Practice Address - Country:US
Practice Address - Phone:718-657-5656
Practice Address - Fax:718-739-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038476-1122300000X
NY054990-1122300000X
NY046075-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty