283 Hurley Ave Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

283 HURLEY AVE DENTAL, PLLC

Doing business as

Dr. Gene DeStefano, DDS

Practice address

283 Hurley Ave
Kingston, NY 12401-2421

Phone

(845) 430-9394

NPI assigned

Oct 13, 2022

Last updated

Oct 13, 2022By 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

Emily Maisch

Title

Director of Operations

Phone

(845) 430-9394

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Gene DeStefano, DDS Doing business as

Locations

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1023734886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012421",
            "telephone_number": "845-430-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012421",
            "telephone_number": "845-430-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "283 HURLEY AVE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "MAISCH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "845-430-9394"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1780690958",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Gene DeStefano, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa J. Abel-Bogner, LCSW
• Badran Abosharr, RN
• Grant Abrams, PT
• Simon Abramson, LCSW
• Elan Adina Abreu, MSW

• Dental Clinic/Center in Kingston, NY
• Providers in Kingston, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.