573 Fordham Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

573 FORDHAM DENTAL PC

Practice address

573 E Fordham Rd
Bronx, NY 10458-5018

Phone

(917) 962-9990

NPI assigned

Feb 18, 2014

Last updated

Feb 18, 2014By 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

Nina Otano

Title

Office Manager

Phone

(917) 962-9990

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shan M Khan, DMD

  • Dentist
  • Brooklyn, NY
  • NPI 1912522095
  NPD (past)

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1043634660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "573 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 E FORDHAM RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585018",
            "telephone_number": "917-962-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "573 FORDHAM DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "OTANO",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "917-962-9990"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.