Hillcrest Dental Associate, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36943 Issued in NY

Legal business name

HILLCREST DENTAL ASSOCIATE, P.C.

Practice address

18011 Union Tpke
Fresh Meadows, NY 11366-1619

Phone

(718) 969-1011

Fax

(718) 376-0034

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Toby Cohen

Title

General Counsel

Phone

(347) 688-9940

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560297600000",
    "number": "1104036946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18011 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661619",
            "telephone_number": "718-969-1011",
            "fax_number": "718-376-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18011 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661619",
            "telephone_number": "718-969-1011",
            "fax_number": "718-376-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLCREST DENTAL ASSOCIATE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-06-12",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "TOBY",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "347-688-9940"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "36943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.