Healthcare Provider Details

I. General information

NPI: 1235175407
Provider Name (Legal Business Name): ARTHUR H KUBIKIAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 EAST 24TH STREET 7W
NEW YORK CITY NY
10010
US

IV. Provider business mailing address

100 CARLYLE DRIVE 9 MN
CLIFFSIDE PARK NJ
07010-3284
US

V. Phone/Fax

Practice location:
  • Phone: 212-998-9428
  • Fax: 718-729-8688
Mailing address:
  • Phone: 516-527-7397
  • Fax: 718-729-8688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number031897
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number031897
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: