NPI Code Detail JSON Logo

1790180693 NPI number — QUEENS ORAL AND FACIAL SURGERY

NPI Number: 1790180693
Health Care Provider/Practitioner: QUEENS ORAL AND FACIAL SURGERY

Information about “1790180693” NPI (QUEENS ORAL AND FACIAL SURGERY) exists in 1790180693 in HTML format HTML  |  1790180693 in plain Text format TXT  |  1790180693 in PDF (Portable Document Format) PDF  |  1790180693 in an XML format XML  formats.

NPI Number : 1790180693 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790180693",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "QUEENS ORAL AND FACIAL SURGERY",
    "ParentOrgTIN": null,
    "OrgName": "QUEENS ORAL AND FACIAL SURGERY",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "40-19 159TH ST.",
    "SecondLineMailingAddress": "1 FL.",
    "MailingAddressCityName": "FLUSHING",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11358",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-358-5488",
    "MailingAddressFaxNumber": "917-285-2676",
    "FirstLinePracticeLocationAddress": "40-19 159TH ST.",
    "SecondLinePracticeLocationAddress": "1 FL.",
    "PracticeLocationAddressCityName": "FLUSHING",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11358",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-358-5488",
    "PracticeLocationAddressFaxNumber": "917-285-2676",
    "EnumerationDate": "11/04/2014",
    "LastUpdateDate": "11/04/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHONG",
    "AuthorizedOfficialFirstName": "JEHYUN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DENTIST",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.D.S",
    "AuthorizedOfficialTelephoneNumber": "718-358-5488",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "051035",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223S0112X",
          "TaxonomyName": "Oral and Maxillofacial Surgery (Dentist)",
          "LicenseNumber": "051829",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "122300000X",
          "TaxonomyName": "Dentist",
          "LicenseNumber": "051051",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.