Gold Coast Dental

Primary specialty

DentistTaxonomy code 122300000X

License

050398 Issued in NY

Legal business name

GOLD COAST DENTAL

Practice address

695 Dutchess Tpke
Suite 104
Poughkeepsie, NY 12603-6442

Phone

(845) 471-8855

NPI assigned

Apr 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Theodore Seyena-Susu, DDS

Title

Dentist

Phone

(845) 471-8855

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.

• Theodore Seyena Susu, DDS

  • Dentist
  • Poughkeepsie, NY
  • NPI 1316082464
  NPD (past)

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1093179574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE",
            "address_2": "SUITE 104",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036442",
            "telephone_number": "845-471-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE",
            "address_2": "SUITE 104",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036442",
            "telephone_number": "845-471-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "SEYENA-SUSU",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "845-471-8855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly A. Godfrey, DO
• Atin Goel, MD
• Janet Goff, PH.D
• Lorraine Gogreve, O.T.
• Maureen Gokey, LPN
• Lisa Gruenhut Gold, N.P.
• Molly Isadora Goldberg, OTR/L
• Golden Care Lhcsa
• Evan R Goldfischer, MD
• Alyson Anne Golding, MS, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.