Peter H Pruden, D.D.S., P.C

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

034661 Issued in NY

Legal business name

PETER H PRUDEN, D.D.S., P.C

Practice address

124 Main St
Suite 2
Huntington, NY 11743-6922

Phone

(631) 421-2471

Fax

(631) 547-6809

NPI assigned

Apr 20, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Peter H Pruden, D.D.S

Title

Oral Surgeon

Phone

(631) 421-2471

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1114160207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "address_2": "SUITE 2",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436922",
            "telephone_number": "631-421-2471",
            "fax_number": "631-547-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "address_2": "SUITE 2",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117436922",
            "telephone_number": "631-421-2471",
            "fax_number": "631-547-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER H PRUDEN, D.D.S., P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "PRUDEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "631-421-2471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "034661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peter Shapiro
• Nikolet Petras, DPT
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• Kaitlin Phelps, MHC-LP
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• Oral and Maxillofacial Surgery (Dentist) in Huntington, NY
• Providers in Huntington, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.