Provider Demographics
NPI:1912996307
Name:ACCUFAST DENTAL, PC
Entity Type:Organization
Organization Name:ACCUFAST DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-359-5675
Mailing Address - Street 1:3719 MAIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4106
Mailing Address - Country:US
Mailing Address - Phone:718-359-5675
Mailing Address - Fax:718-359-5774
Practice Address - Street 1:3719 MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4106
Practice Address - Country:US
Practice Address - Phone:718-359-5675
Practice Address - Fax:718-359-5774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0479881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01977224Medicaid