1995 Broadway Dental Arts PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

040754 Issued in NY

Legal business name

1995 BROADWAY DENTAL ARTS PLLC

Practice address

1995 Broadway
New York, NY 10023-5882

Phone

(212) 247-2330

NPI assigned

Aug 24, 2015

Organization subpart

No

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

Authorized official

Name

Marc Liechtung, DDS

Title

President

Phone

(732) 610-8265

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440374400000",
    "number": "1144697368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235882",
            "telephone_number": "212-247-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235882",
            "telephone_number": "212-247-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1995 BROADWAY DENTAL ARTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A",
        "authorized_official_last_name": "LIECHTUNG",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-610-8265",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "040754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.