Provider Demographics
NPI:1811293111
Name:BORINOS, TATIANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:BORINOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63-60 102 STREET
Mailing Address - Street 2:REGO PARK
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:718-896-3100
Mailing Address - Fax:718-896-0304
Practice Address - Street 1:63-60 102ND STREET
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:10463
Practice Address - Country:US
Practice Address - Phone:718-896-3100
Practice Address - Fax:718-896-0304
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0486011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics