NPIMap

Organization Active NPI

Jpda Dental Services PLLC

  • Dental Clinic/Center
  • Freeport, NY
National Provider Identifier
1063257905
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
JPDA DENTAL SERVICES PLLC
Practice address
268 W Merrick Rd
Freeport, NY 11520-3347
Phone
(516) 378-3200
NPI assigned
Jul 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Jacob J Pleshty, DDSNPI 1144865189
Title
Co-Owner
Phone
(646) 875-0223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

268 W Merrick Rd
Freeport, NY 11520-3347

Mailing address

268 W Merrick Rd
Freeport, NY 11520-3347
Phone (516) 378-3200

Other names 1

  • Iconic Smiles of Freeport Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1063257905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203347",
            "telephone_number": "516-378-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 W MERRICK RD",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203347",
            "telephone_number": "516-378-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JPDA DENTAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "PLESHTY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "646-875-0223",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iconic Smiles of Freeport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.