JACKSON HEIGHTS DENTAL MR PC NPI 1760452106

NPI Information

NPI: 1760452106
Provider Name: JACKSON HEIGHTS DENTAL MR, PC
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
:
Address: 8509 37TH AVE
JACKSON HEIGHTS, NY
ZIP 11372
Phone: (718) 651-4523

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NPI Details

JACKSON HEIGHTS DENTAL MR, PC is a general practice dentist in Jackson Heights, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. JACKSON HEIGHTS DENTAL MR, PC NPI is 1760452106. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

8509 37TH AVE
JACKSON HEIGHTS, NY
ZIP 11372-344
Phone: (718) 651-4523

The provider's authorized official is Mark David Lorber .
The authorized official title is Owner and has the following contact phone number (718) 651-4523.

The enumeration date for this NPI number is 1/26/2006 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		047347	NEW YORK	No
2	122300000X	Dentist		046409	NEW YORK	No
3	1223P0300X	Dentist	Periodontics	047303	NEW YORK	No
4	1223G0001X	Dentist	General Practice	052071	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01912481	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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