Organization Active NPI

Nu Dental PC

Doing business as NU Dental

  • Dental Clinic/Center
  • Staten Island, NY
National Provider Identifier
1245871029
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NU DENTAL PC
Doing business as
NU Dental
Practice address
76 Pond St
Staten Island, NY 10309-1797
Phone
(718) 568-0405
NPI assigned
Oct 3, 2019
Last updated
Oct 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Authorized official

Name
Dr. Admasu N Gizahew, DDS
Title
Owner/Director
Phone
(718) 568-0405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

76 Pond St
Staten Island, NY 10309-1797

Mailing address

16 Riverside LN
Holmdel, NJ 07733-2084

Other names 1

  • NU Dental Doing business as

National Provider Directory

National Provider Directory

Locations

76 Pond St
Staten Island, NY 10309
Phone (718) 568-0405

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1245871029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RIVERSIDE LN",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 POND ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091797",
            "telephone_number": "718-568-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NU DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "GIZAHEW",
        "authorized_official_first_name": "ADMASU",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "718-568-0405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NU Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.