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General NPI Number Information
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NPI Number | 1790621506
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Entity Type | Organization
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Legal Business Name | 1196 LEXINGTON DENTAL LLC
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 330 E 72ND ST APT 7
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City | NEW YORK
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State | NY
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Zip | 10021-4728
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Country | US
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Telephone | 212-879-1845
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Fax |
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Provider Business Mailing Address
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Address Line | 330 E 72ND ST APT 7
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City | NEW YORK
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State | NY
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Zip | 10021-4728
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Country | US
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Telephone | 212-879-1845
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JEFFREY RAPPAPORT
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Credential | DDS
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Telephone | 415-530-2228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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