NPIMap

Organization Active NPI

A-Gold Coast Family Dental

  • Dentist
  • Port Washington, NY
National Provider Identifier
1174705768
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
A-GOLD COAST FAMILY DENTAL
Practice address
2 Cow Neck Rd
Port Washington, NY 11050-1712
Phone
(516) 883-8810
NPI assigned
Dec 5, 2007
Last updated
Dec 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. Doron Keren, D.D.S.NPI 1578789814
Title
President
Phone
(516) 883-8810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

2 Cow Neck Rd
Port Washington, NY 11050-1712

Mailing address

2 Cow Neck Rd
Port Washington, NY 11050-1712
Phone (516) 883-8810

Other identifiers 1

IdentifierTypeStateIssuer
02241743MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
A-Gold Coast Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1174705768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COW NECK RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501712",
            "telephone_number": "516-883-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COW NECK RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110501712",
            "telephone_number": "516-883-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A-GOLD COAST FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "KEREN",
        "authorized_official_first_name": "DORON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-883-8810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02241743",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.