57 Central Dental Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

051275 Issued in NY

Legal business name

57 CENTRAL DENTAL PROFESSIONAL CORPORATION

Practice address

57 W 57TH St Ste 710
New York, NY 10019-2802

Phone

(212) 564-1888

Fax

(212) 564-1161

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jung-Hun Kim, DDS

Title

President

Phone

(917) 442-9164

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jung-Min Kim, DDS

  • Dentist
  • New York, NY
  • NPI 1174679740
  NPD (past)

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1134628415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD PALISADE RD APT 2705",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247022",
            "telephone_number": "917-442-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST STE 710",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "212-564-1888",
            "fax_number": "212-564-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "57 CENTRAL DENTAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JUNG-HUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-442-9164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051275",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.