Provider Demographics
NPI:1528621588
Name:NASH DENTAL P.C.
Entity type:Organization
Organization Name:NASH DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:NASHTATIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-295-9214
Mailing Address - Street 1:226 LIVINGSTON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5877
Mailing Address - Country:US
Mailing Address - Phone:718-596-0066
Mailing Address - Fax:
Practice Address - Street 1:226 LIVINGSTON ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5877
Practice Address - Country:US
Practice Address - Phone:718-596-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental