Professional Dental Office PC.

Primary specialty

DentistTaxonomy code 122300000X

License

048431-1 Issued in NY

Legal business name

PROFESSIONAL DENTAL OFFICE PC.

Practice address

167 Rivington St
1St Floor
New York, NY 10002-2555

Phone

(212) 673-9367

Fax

(212) 673-9367

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Rosa Idalia Diaz, DDS,

Title

President

Phone

(212) 673-9367

Specialties & licenses 1

Addresses

Tax ID family

Professional Dental Office PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Professional Dental Office PC

  • Dentist
  • New York, NY
  • NPI 1457320301
  NPD tax ID

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1073659074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 RIVINGTON ST",
            "address_2": "1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022555",
            "telephone_number": "212-673-9367",
            "fax_number": "212-673-9367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 RIVINGTON ST",
            "address_2": "1ST FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100022555",
            "telephone_number": "212-673-9367",
            "fax_number": "212-673-9367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL OFFICE PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "IDALIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-673-9367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "048431-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenore F Proctor, PSYD
• Iordanka P Prodanova, DDS
• Professional Car Service
• Professional Clinical Laboratories
• Professional Dental Office PC
• Professional Dental Service
• Professional Evaluation Medical Group
• Professional Medical Healthcare Service of New York
• Professional Medical Healthcare Service of New York, PC
• Professional Medical Healthcare Services of New York

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.