Organization Active NPI

Jurim Dental Group

  • General Practice Dentistry
  • Woodbury, NY
National Provider Identifier
1164877288
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054399 Issued in NY
Legal business name
JURIM DENTAL GROUP
Practice address
370 Crossways Park Dr
Woodbury, NY 11797-2050
Phone
(516) 677-9010
NPI assigned
Apr 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Authorized official

Name
Adam Richichi
Title
Chief Operating Officer
Phone
(516) 677-9010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 054399 NY Primary

Addresses

Primary practice location

370 Crossways Park Dr
Woodbury, NY 11797-2050

Mailing address

370 Crossways Park Dr
Woodbury, NY 11797-2050
Phone (516) 677-9010

Other names 1

  • integratedDENTAL Doing business as

National Provider Directory

National Provider Directory

Locations

370 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 677-9010

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": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461628800000",
    "number": "1164877288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972050",
            "telephone_number": "516-677-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972050",
            "telephone_number": "516-677-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JURIM DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A",
        "authorized_official_last_name": "RICHICHI",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "516-677-9010"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "integratedDENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.