NPIMap

Organization Active NPI

Ebenezer Dental, PLLC

  • Prosthodontics
  • New York, NY
National Provider Identifier
1164759296
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
049153 Issued in NY
Legal business name
EBENEZER DENTAL, PLLC
Practice address
474 7TH Ave
Floor #4
New York, NY 10018-7673
Phone
(212) 687-4400
NPI assigned
Nov 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Karen K Kang, D.D.S.NPI 1437281151
Title
Dr.
Phone
(212) 687-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X 049153 NY Primary

Addresses

Primary practice location

474 7TH Ave
Floor #4
New York, NY 10018-7673

Mailing address

474 7TH Ave
Floor #4
New York, NY 10018-7673
Phone (212) 687-4400

National Provider Directory

National Provider Directory

Locations

474 7th Ave
Fl 4
New York, NY 10018
Phone (212) 687-4400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1164759296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 7TH AVE",
            "address_2": "FLOOR #4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187673",
            "telephone_number": "212-687-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 7TH AVE",
            "address_2": "FLOOR #4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187673",
            "telephone_number": "212-687-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "212-687-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "049153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; 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.