New York Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

047030 Issued in NY

Legal business name

NEW YORK DENTAL GROUP

Practice address

14448 Roosevelt Ave
Ste. MD-B
Flushing, NY 11354-6232

Phone

(718) 886-4545

NPI assigned

Apr 1, 2017

Last updated

Apr 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason Kim, DDSNPI 1790793750

Title

Owner

Phone

(718) 886-4545

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Luma Dental PC

  • General Practice Dentistry
  • New York, NY
  • NPI 1548432263
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Kim, DDS

  • Dentist
  • Flushing, NY
  • NPI 1790793750
  NPD (past) Authorized official

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491004800000",
    "number": "1144752726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14448 ROOSEVELT AVE",
            "address_2": "STE. MD-B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546232",
            "telephone_number": "718-886-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14448 ROOSEVELT AVE",
            "address_2": "STE. MD-B",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546232",
            "telephone_number": "718-886-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-01",
        "last_updated": "2017-04-01",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-886-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Flushing, NY
• Providers in Flushing, 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 1, 2017; 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.