Advanced Dental Anesthesia Services

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

D102532800 Issued in NJ

Legal business name

ADVANCED DENTAL ANESTHESIA SERVICES

Practice address

111 Route 303
Suite 220
Tappan, NY 10983-2133

Phone

(845) 848-2255

NPI assigned

Mar 15, 2016

Last updated

Mar 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosalie Mendia

Title

Office Manager

Phone

(201) 660-7464

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458000000000",
    "number": "1023479359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 BI STATE PLZ # 268",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757003",
            "telephone_number": "201-660-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ROUTE 303",
            "address_2": "SUITE 220",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109832133",
            "telephone_number": "845-848-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL ANESTHESIA SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-15",
        "last_updated": "2016-03-15",
        "status": "A",
        "authorized_official_last_name": "MENDIA",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-660-7464"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NJ",
            "license": "D102532800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.