Provider Demographics
NPI:1306989264
Name:STEVEN H. GOLD, D.D.S., P.C.
Entity type:Organization
Organization Name:STEVEN H. GOLD, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-897-2900
Mailing Address - Street 1:97-37 63RD ROAD
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-897-2900
Mailing Address - Fax:718-897-6363
Practice Address - Street 1:97-37 63RD ROAD
Practice Address - Street 2:SUITE 1K
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-897-2900
Practice Address - Fax:718-897-6363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
NY0301661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00286315Medicaid