MEDICARE: JAY B. LUBLINER, DMD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	044867	NY

General Provider Information

NPI Number	:	1831192376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAY B. LUBLINER, DMD, PLLC

Provider Business Mailing Address
First Line	:	89 GRAND AVE
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-4905
Country	:	US
Telephone Number	:	516-798-0223
Fax Number	:	516-798-1970

Provider Business Practice Location Address
First Line	:	89 GRAND AVE
Second Line	:
City	:	MASSAPEQUA
State	:	NY
Zip	:	11758-4905
Country	:	US
Telephone Number	:	516-798-0223
Fax Number	:	516-798-1970

Authorized Official
Title or Position	:	SOLE MEMBER/OWNER
Name	:	DR. JAY LUBLINER
Credential	:	D.M.D.
Telephone Number	:	516-798-0223

Provider Enumeration Date	:	05/29/2005
Last Update Date	:	08/20/2013

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