P.C. Dental Group PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

0564181 Issued in NY

Legal business name

P.C. DENTAL GROUP PLLC

Practice address

1 Gateway PLZ
Port Chester, NY 10573-4674

Phone

(914) 481-5733

Fax

(914) 481-5729

NPI assigned

Dec 28, 2012

Last updated

Dec 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stuart Graber, DDS

Title

Managing Dentist

Phone

(914) 481-5733

Specialties & licenses 8

Addresses

Locations

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1235475989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GATEWAY PLZ",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734674",
            "telephone_number": "914-481-5733",
            "fax_number": "914-481-5729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GATEWAY PLZ",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734674",
            "telephone_number": "914-481-5733",
            "fax_number": "914-481-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.C. DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "GRABER",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "MANAGING DENTIST",
        "authorized_official_telephone_number": "914-481-5733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "030324",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0561931",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0554981",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0513121",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0564181",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "0518851",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "0451461",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "339246134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Port Chester, NY
• Providers in Port Chester, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.