Pesantes Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046461 Issued in NY

Legal business name

PESANTES DENTAL PC

Practice address

11109 Jamaica Ave
Richmond Hill, NY 11418-2323

Phone

(718) 850-1011

Fax

(718) 850-6086

NPI assigned

Jun 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Juan J Pesantes, D.D.S.

Title

President

Phone

(718) 850-1011

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1245525351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182323",
            "telephone_number": "718-850-1011",
            "fax_number": "718-850-6086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 JAMAICA AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182323",
            "telephone_number": "718-850-1011",
            "fax_number": "718-850-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PESANTES DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "PESANTES",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-850-1011",
        "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": "046461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01738614",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Perez Jr., MD
• Angela Nalini Persaud, PMHNP
• Janet Persaud
• Keisha Ashley Persaud, SLP-CF
• Padma Persaud, RPA
• PG USA Inc
• Sherrence Bidya Phagoo, NP
• Soraya Pharel
• Priya Philip, PHARM D
• Angela Phillips

• General Practice Dentistry in Richmond Hill, NY
• Providers in Richmond Hill, 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 Jun 16, 2011; 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.