NPIMap

Organization Active NPI

Prohealth Riverside Dental, LLC

  • Dentist
  • Edgewater, NJ
National Provider Identifier
1073151114
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROHEALTH RIVERSIDE DENTAL, LLC
Practice address
125 River Rd Ste 104
Edgewater, NJ 07020-1002
Phone
(201) 941-0088
NPI assigned
Dec 19, 2019
Last updated
Dec 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Authorized official

Name
Neil Karnofsky, DDS
Title
Managing Partner
Phone
(516) 654-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

125 River Rd Ste 104
Edgewater, NJ 07020-1002

Mailing address

1 Pro Health PLZ Ste 300
New Hyde Park, NY 11042
Phone (516) 654-4400

National Provider Directory

National Provider Directory
Tax ID family
Prohealth Riverside Dental LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1073151114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRO HEALTH PLZ STE 300",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042",
            "telephone_number": "516-654-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RIVER RD STE 104",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201002",
            "telephone_number": "201-941-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH RIVERSIDE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "KARNOFSKY",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "516-654-4400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.