East 4TH Street Dental PLLC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

EAST 4TH STREET DENTAL PLLC

Practice address

101 East 4TH Street
New York, NY 10003

Phone

(212) 239-7027

NPI assigned

Apr 26, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Dmitriy Volotsenko, DDS

Title

Managing Member

Phone

(917) 797-8052

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sara Shahi, DDS

  • Pediatric Dentistry
  • New York, NY
  • NPI 1902153703
  NPD (past)

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556236800000",
    "number": "1205490182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EAST 4TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-239-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EAST 4TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-239-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST 4TH STREET DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A",
        "authorized_official_last_name": "VOLOTSENKO",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "917-797-8052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in New York, NY
• Providers in New York, NY by specialty
• Public Health Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.