Provider Demographics
NPI:1306047451
Name:NY DENTAL IMPLANTS & COSMETICS CORP
Entity type:Organization
Organization Name:NY DENTAL IMPLANTS & COSMETICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:AYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-763-8282
Mailing Address - Street 1:366 5TH AVE
Mailing Address - Street 2:SUITE 709
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2211
Mailing Address - Country:US
Mailing Address - Phone:646-763-8282
Mailing Address - Fax:212-629-3466
Practice Address - Street 1:366 5TH AVE
Practice Address - Street 2:SUITE 709
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2211
Practice Address - Country:US
Practice Address - Phone:646-763-8282
Practice Address - Fax:212-629-3466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0465461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty