Organization Active NPI

Blumenthal & Associates DDS PC

  • Dentist
  • Long Island City, NY
National Provider Identifier
1215918495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BLUMENTHAL & ASSOCIATES DDS PC
Practice address
3447 21St St
Blumenthal and Associates DDS PC
Long Island City, NY 11106-4721
Phone
(718) 786-8667
Fax
(718) 786-8531
NPI assigned
Nov 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter David Blumenthal, DDS
Title
President
Phone
(718) 786-8667

Specialties & licenses 1

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

Addresses

Primary practice location

3447 21St St
Blumenthal and Associates DDS PC
Long Island City, NY 11106-4721

Mailing address

3447 21St St
Blumenthal and Associates DDS PC
Long Island City, NY 11106-4721
Phone (718) 786-8667

Other identifiers 1

IdentifierTypeStateIssuer
00748210MedicaidNY

National Provider Directory

National Provider Directory

Locations

3447 21st St
Long Island City, NY 11106
Phone (718) 786-8667

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215918495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 21ST ST",
            "address_2": "BLUMENTHAL AND ASSOCIATES DDS PC",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064721",
            "telephone_number": "718-786-8667",
            "fax_number": "718-786-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3447 21ST ST",
            "address_2": "BLUMENTHAL AND ASSOCIATES DDS PC",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064721",
            "telephone_number": "718-786-8667",
            "fax_number": "718-786-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUMENTHAL & ASSOCIATES DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLUMENTHAL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-786-8667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00748210",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.