NPIMap

Organization Active NPI

Periodontal & Implant Surgery Associates

  • Periodontics
  • Franklin Square, NY
National Provider Identifier
1275622086
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
040277 Issued in NY
Legal business name
PERIODONTAL & IMPLANT SURGERY ASSOCIATES
Practice address
393 Franklin Ave
Suite 103
Franklin Square, NY 11010-1222
Phone
(516) 354-5228
Fax
(516) 354-8006
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
Dr. Anthony Ienna, DDSNPI 1750401600
Title
Owner
Phone
(516) 354-5228

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 040277 NY Primary

Addresses

Primary practice location

393 Franklin Ave
Suite 103
Franklin Square, NY 11010-1222

Mailing address

393 Franklin Ave
Suite 103
Franklin Square, NY 11010-1222
Phone (516) 354-5228

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1275622086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 FRANKLIN AVE",
            "address_2": "SUITE 103",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101222",
            "telephone_number": "516-354-5228",
            "fax_number": "516-354-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 FRANKLIN AVE",
            "address_2": "SUITE 103",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110101222",
            "telephone_number": "516-354-5228",
            "fax_number": "516-354-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL & IMPLANT SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "IENNA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-354-5228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "040277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Square, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.