Corona 26 Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

055939 Issued in NY

Legal business name

CORONA 26 DENTAL GROUP

Practice address

10308 Roosevelt Ave
2ND Floor
Corona, NY 11368-2330

Phone

(718) 397-7000

NPI assigned

Sep 22, 2014

Organization subpart

No

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

Authorized official

Name

Alicia A Pitkouvich

Title

Manager

Phone

(917) 391-8000

Specialties & licenses 1

Addresses

Other names 1

• Corona Pediatric Dental Plaza Doing business as

Locations

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1245632207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10308 ROOSEVELT AVE",
            "address_2": "2ND FLOOR",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-397-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10308 ROOSEVELT AVE",
            "address_2": "2ND FLOOR",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-397-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA 26 DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "PITKOUVICH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-391-8000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "055939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Pediatric Dental Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ricardo Comissiong
• Cooperativa Colombiana de Conductores, Inc
• Violet Corbella
• Sherrie Amelia Corbin, L.P.N.
• Greg Corley
• Corona 26 Medical & Dental Management PLLC
• Corona Adult Daycare
• Corona Adult Social Day Care Center LLC
• Corona Chiropractic Health Services P.C.
• Corona Community Ambulance Corps, Inc.

• Dentist in Corona, NY
• Providers in Corona, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.