NPIMap

Organization Active NPI

Distinctive Dental Services of New York PC

  • Pediatric Dentistry
  • Great Neck, NY
National Provider Identifier
1205970332
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DISTINCTIVE DENTAL SERVICES OF NEW YORK PC
Practice address
173 E Shore Rd
Suite 201
Great Neck, NY 11023-2415
Phone
(516) 487-8110
Fax
(516) 487-8394
NPI assigned
Feb 20, 2007
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Ralph Harris Epstein, DDSNPI 1750414744
Title
President
Phone
(516) 487-8110

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 054882 NY
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 34227 NY
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 054882 NY
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

173 E Shore Rd
Suite 201
Great Neck, NY 11023-2415

Mailing address

173 East Shore Rd
Suite 201
Great Neck, NY 11023
Phone (516) 487-8110

National Provider Directory

National Provider Directory

Locations

173 E Shore Rd
Ste 201
Great Neck, NY 11023
Phone (516) 487-8110

Practitioners & affiliated clinicians

Practitioners 7

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1205970332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 EAST SHORE RD",
            "address_2": "SUITE 201",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "11023",
            "telephone_number": "516-487-8110",
            "fax_number": "516-487-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 E SHORE RD",
            "address_2": "SUITE 201",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232415",
            "telephone_number": "516-487-8110",
            "fax_number": "516-487-8394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE DENTAL SERVICES OF NEW YORK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "EPSTEIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-487-8110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "054882",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NY",
            "license": "34227",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NY",
            "license": "054882",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.