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NPI Code Detail

MEDICARE: DAVIDS DENTISTRY PC

MEDICARE: DAVIDS DENTISTRY PC
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
11223G0001XGeneral Practice Dentistry057332NY

General Provider Information

NPI Number : 1548786064
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVIDS DENTISTRY PC
Provider Business Mailing Address
First Line : 10911 JAMAICA AVE
Second Line :
City : RICHMOND HILL
State : NY
Zip : 11418-2335
Country : US
Telephone Number : 718-441-4411
Fax Number : 718-441-4412
Provider Business Practice Location Address
First Line : 10605 JAMAICA AVE
Second Line :
City : RICHMOND HILL
State : NY
Zip : 11418-2016
Country : US
Telephone Number : 718-441-4411
Fax Number : 718-441-4412
Authorized Official
Title or Position : PRESIDENT
Name : DR. KINSUN DAVID FUNG
Credential : DMD, MS
Telephone Number : 718-441-4411
Provider Enumeration Date : 08/16/2017
Last Update Date : 07/21/2022

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Directions to “DAVIDS DENTISTRY PC ” Practice Location

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