Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508919820 Individual Practitioner Male Practitioner

Dr. Dmitry Gorbunov , DDS

Dentist - General Practice • Elmhurst, NY

Professional Overview & Biography Verified Profile Summary

Dr. Dmitry Gorbunov, DDS is a registered healthcare professional specializing in Dentist - General Practice in Elmhurst, NY. Practice services are available at 9123 QUEENS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9123 Queens Blvd

Elmhurst, NY 113735531

Telephone 7189438680
Fax 7189438683
Associated Practice Facility / Clinic
🏢 G Dental Pc Facility NPI 1609024231

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Elmhurst, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
50 Specialists

Practicing in Elmhurst, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 043066-1

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
01214108 (NY)
Commercial Insurance / Payer ID Doral
9178486 (NY)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 12, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location January 12, 2009

Registered at 9123 QUEENS BLVD, ELMHURST, NY 113735531 (Tel: 7189438680)

📍
Updated Business Mailing Address January 12, 2009

Registered at 9123 QUEENS BLVD, ELMHURST, NY 113735531 (Tel: 7189438680)

👤
Provider Name / Credentials Updated January 12, 2009

Recorded as DMITRY GORBUNOV, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 12, 2009

Dentist (License #043066-1 in NY)

🟢
Initial NPI Registration & Enumeration January 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508919820
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 19, 2007
Last Update: January 12, 2009
Sole Proprietor: Yes

Mailing Address

9123 Queens Blvd

Elmhurst, NY 113735531

Phone: 7189438680

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.