P.D.M Family Dental, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

053657 Issued in NY

Legal business name

P.D.M FAMILY DENTAL, P.C.

Practice address

295 N Broadway
Jericho, NY 11753

Phone

(516) 388-5002

NPI assigned

Jan 5, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Parul Dua Makkar, D.D.S

Title

President

Phone

(516) 592-1555

Specialties & licenses 1

Addresses

Other names 1

• PM Dental, P.C. Former legal business name

Locations

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1225545718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 TALON WAY",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "11746",
            "telephone_number": "516-388-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N BROADWAY",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "11753",
            "telephone_number": "516-388-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.D.M FAMILY DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "MAKKAR",
        "authorized_official_first_name": "PARUL",
        "authorized_official_middle_name": "DUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-592-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PM Dental, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• General Practice Dentistry in Jericho, NY
• Providers in Jericho, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.