Provider Demographics
NPI:1962177550
Name:LADINO DENTAL PLLC
Entity type:Organization
Organization Name:LADINO DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LADINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-854-5645
Mailing Address - Street 1:3756 103RD ST BSMT
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-5163
Mailing Address - Country:US
Mailing Address - Phone:917-854-5645
Mailing Address - Fax:
Practice Address - Street 1:3756 103RD ST BSMT
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-5163
Practice Address - Country:US
Practice Address - Phone:917-854-5645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental