Healthcare Provider Details

I. General information

NPI: 1760917025
Provider Name (Legal Business Name): ARSEN MURDAKHAYEV DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 09/29/2026
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8148 189TH ST
HOLLIS NY
11423-1037
US

IV. Provider business mailing address

8148 189TH ST
HOLLIS NY
11423-1037
US

V. Phone/Fax

Practice location:
  • Phone: 347-701-4292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number059862
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: