Provider Demographics
NPI:1215512082
Name:FLATIRON FAMILY DENTAL, PC
Entity type:Organization
Organization Name:FLATIRON FAMILY DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMONOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-693-4402
Mailing Address - Street 1:34 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5709
Mailing Address - Country:US
Mailing Address - Phone:212-510-7303
Mailing Address - Fax:
Practice Address - Street 1:34 W 17TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5709
Practice Address - Country:US
Practice Address - Phone:212-510-7303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental