Family Dental Associates LLP

Primary specialty

DentistTaxonomy code 122300000X

License

046460 Issued in NY

Legal business name

FAMILY DENTAL ASSOCIATES LLP

Practice address

211 Park Ave
Mechanicville, NY 12118

Phone

(518) 664-0762

Fax

(518) 664-0765

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Petra Victoria Enzien, DMD

Title

Dentist Partner

Phone

(518) 664-0762

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164451035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PARK AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-664-0762",
            "fax_number": "518-664-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PARK AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "12118",
            "telephone_number": "518-664-0762",
            "fax_number": "518-664-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENZIEN",
        "authorized_official_first_name": "PETRA",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "DENTIST PARTNER",
        "authorized_official_telephone_number": "518-664-0762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046460",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0461981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis M Dellacroce, DC
• Daniel Doran Dennett, MS,ATC
• Lynn Dorr, LCSW
• Petra V. Enzien, DMD
• Erin Summers Speech Therapy Inc
• Family Medicine of Mechanicville PLLC
• McKenzie Leigh Flemming, PA-C
• Mary E Ford, RN
• Sierra Frederick, LMSW
• Melissa Fronhofer, MSPT

• Dentist in Mechanicville, NY
• Providers in Mechanicville, 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 22, 2020; 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.