NPIMap

Organization Active NPI

Illustradent Westchester Dental Services, PLLC

  • Dentist
  • Yonkers, NY
National Provider Identifier
1184921520
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052858 Issued in NY
Legal business name
ILLUSTRADENT WESTCHESTER DENTAL SERVICES, PLLC
Doing business as
Cross County Dental Group
Practice address
1730 Central Park Ave
2ND Floor
Yonkers, NY 10710-4905
Phone
(914) 779-4858
Fax
(914) 395-0101
NPI assigned
Feb 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Dr. Mara Paige Rosenberg, DDS
Title
Member
Phone
(914) 779-4858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 052858 NY Primary

Addresses

Primary practice location

1730 Central Park Ave
2ND Floor
Yonkers, NY 10710-4905

Mailing address

1730 Central Park Ave
2ND Floor
Yonkers, NY 10710-4905
Phone (914) 779-4858

Other names 1

  • Cross County Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cross County Dental Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1184921520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 CENTRAL PARK AVE",
            "address_2": "2ND FLOOR",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107104905",
            "telephone_number": "914-779-4858",
            "fax_number": "914-395-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 CENTRAL PARK AVE",
            "address_2": "2ND FLOOR",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107104905",
            "telephone_number": "914-779-4858",
            "fax_number": "914-395-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUSTRADENT WESTCHESTER DENTAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "MARA",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "914-779-4858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "052858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cross County Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.