NPIMap

Organization Active NPI

Madison Avenue Periodontics, P.C.

Doing business as Madison Avenue Periodontics

  • Dentist
  • Ny, NY
National Provider Identifier
1275606865
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047299 Issued in NY
Legal business name
MADISON AVENUE PERIODONTICS, P.C.
Doing business as
Madison Avenue Periodontics
Practice address
501 Madison Ave
22ND Floor
Ny, NY 10022
Phone
(212) 755-1144
Fax
(212) 371-9629
NPI assigned
Nov 15, 2006
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Jenny Garcia-Rocha
Title
Sr Credentialing Team Lead
Phone
(972) 869-3789

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35077 NY
Dentist 122300000X 041733 NY
Dentist 122300000X 047299 NY Primary

Addresses

Primary practice location

501 Madison Ave
22ND Floor
Ny, NY 10022

Mailing address

501 Madison Ave
22ND Floor
Ny, NY 10022
Phone (212) 755-1144

Other names 2

  • Madison Avenue Periodontics Doing business as
  • Matthew Neary DDS & John Lanzetta DMD PC Former legal business name

National Provider Directory

National Provider Directory

Locations

501 Madison Ave
Fl 22
New York, NY 10022
Phone (212) 755-1144

Practitioners & affiliated clinicians

Practitioners 5

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": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1275606865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "address_2": "22ND FLOOR",
            "city": "NY",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-755-1144",
            "fax_number": "212-371-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MADISON AVE",
            "address_2": "22ND FLOOR",
            "city": "NY",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-755-1144",
            "fax_number": "212-371-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVENUE PERIODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "35077",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041733",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Avenue Periodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Matthew Neary DDS & John Lanzetta DMD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Matthew Neary DDS & John Lanzetta DMD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ny, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.