12TH Street Dental PLLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

051610 Issued in NY

Legal business name

12TH STREET DENTAL PLLC

Practice address

77 E 12TH St
New York, NY 10003-5002

Phone

(917) 915-4504

NPI assigned

Sep 6, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Janash, DMD

Title

President and Ceo

Phone

(917) 915-4504

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1013499052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CENTRAL PARK S RM 13C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191646",
            "telephone_number": "212-355-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E 12TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100035002",
            "telephone_number": "917-915-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "12TH STREET DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "JANASH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "917-915-4504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "NY",
            "license": "051610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in New York, NY
• Providers in New York, NY by specialty
• Public Health Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.