Gomez, Jorge Luis

Gomez, Jorge Luis is an individual health care provider with primary practice located at 8397 Woodhaven Blvd , Woodhaven NY 11421-1531. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Gomez, Jorge Luis can be contacted via phone (718) 805-0450.

Contact Information

Primary practice address
8397 Woodhaven Blvd Woodhaven NY 11421-1531
Phone: (718) 805-0450
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 040435 New York

Profile Details

NPI number 1144203878
LBN Legal business name Gomez, Jorge Luis
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144203878 NPPES
New York MEDICAID 01248897

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