Gorbunov, Dmitry
Gorbunov, Dmitry is an sole proprietor health care provider with primary practice located at 9123 Queens Blvd , Elmhurst NY 11373-5531. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gorbunov, Dmitry can be contacted via phone (718) 943-8680.Contact Information
Primary practice address
9123 Queens Blvd
Elmhurst NY 11373-5531
Phone: (718) 943-8680
Fax: (718) 943-8683
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 043066-1 | New York |
Profile Details
| NPI number | 1508919820 |
|---|---|
| LBN Legal business name | Gorbunov, Dmitry |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jan 12th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508919820 | NPPES |
| New York | Other | 9178486 | DORAL |
| New York | MEDICAID | 01214108 | DORAL |
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