Provider Demographics
NPI:1013536846
Name:RUBINOV, ISAAK (DDS)
Entity type:Individual
Prefix:DR
First Name:ISAAK
Middle Name:
Last Name:RUBINOV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14444 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2402
Mailing Address - Country:US
Mailing Address - Phone:347-288-8729
Mailing Address - Fax:
Practice Address - Street 1:426 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1431
Practice Address - Country:US
Practice Address - Phone:516-744-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-12
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0617201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice