NPIMap

Organization Active NPI

Dental Specialty Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1275592693
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
DENTAL SPECIALTY ASSOCIATES PC
Practice address
225 Broadway
Suite #105
New York, NY 10007-3001
Phone
(212) 374-9500
Fax
(212) 732-0267
NPI assigned
Mar 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paul Irving Cohen, DDSNPI 1043201759
Title
President
Phone
(212) 374-9500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X Primary

Addresses

Primary practice location

225 Broadway
Suite #105
New York, NY 10007-3001

Mailing address

225 Broadway
Suite #105
New York, NY 10007-3001
Phone (212) 374-9500

Other identifiers 1

IdentifierTypeStateIssuer
02593511MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151005002970 NY Part B Supplier - Clinic/Group Practice 6608184015 Receives reassigned benefits from 4 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Tax ID family
Dental Specialty Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

225 Broadway
Ste 105
New York, NY 10007
Phone (212) 374-9500

Practitioners & affiliated clinicians

Practitioners 6

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": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275592693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BROADWAY",
            "address_2": "SUITE #105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "212-374-9500",
            "fax_number": "212-732-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADWAY",
            "address_2": "SUITE #105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "212-374-9500",
            "fax_number": "212-732-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALTY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "IRVING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-374-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02593511",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.