Orthodontics at Jackson Heights Smiles, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

050711 Issued in NY

Legal business name

ORTHODONTICS AT JACKSON HEIGHTS SMILES, PLLC

Practice address

3062 79TH St
2ND Floor
East Elmhurst, NY 11370-1510

Phone

(718) 426-9400

Fax

(718) 426-9497

NPI assigned

Apr 10, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Saju Mathew, D.D.S.

Title

Owner

Phone

(631) 235-9007

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1083033773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 70TH ST",
            "address_2": "APT 1101",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100234304",
            "telephone_number": "631-235-9007",
            "fax_number": "212-954-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3062 79TH ST",
            "address_2": "2ND FLOOR",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113701510",
            "telephone_number": "718-426-9400",
            "fax_number": "718-426-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTICS AT JACKSON HEIGHTS SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "SAJU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-235-9007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "050711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03128301",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl A. Nurse, LCSW
• Nyc Dohmh Department of School Heath
• Nyc Health and Hospitals Corporation
• Oms Podiatry Services PC
• Selma Ortega
• Cristal Ortiz
• Yamile Ossa
• Maribel Otero
• Savira Pai, D.D.S
• Taihri Panora

• Orthodontics and Dentofacial Orthopedics Dentistry in East Elmhurst, NY
• Providers in East Elmhurst, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.