# SIMON BANGIYEV DDS, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SIMON BANGIYEV, DDS, MD, PC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700445194
- **Legal business name:** SIMON BANGIYEV, DDS, MD, PC.
- **Authorized official:** DR. SIMON BANGIYEV DDS, MD. (OWNER)
- **Authorized official phone:** (718) 805-6000

## Contact information

- **Practice address:** 10232 JAMAICA AVE, RICHMOND HILL, NY 11418-2009
- **Practice address phone:** (718) 805-6000
- **Mailing address:** 10232 JAMAICA AVE, RICHMOND HILL, NY 11418-2009
- **Mailing address phone:** (718) 805-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2019
- **Last updated:** 06/10/2019