NPIMap

Organization Active NPI

Emblemhealth Medical and Dental Services Inc.

  • Health Service Clinic/Center
  • Albany, NY
National Provider Identifier
1275823734
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
0101222R Issued in NY
Legal business name
EMBLEMHEALTH MEDICAL AND DENTAL SERVICES INC.
Practice address
1873 Western Ave
Suite 200
Albany, NY 12203-5028
Phone
(518) 869-1044
Fax
(518) 869-1965
NPI assigned
Apr 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Authorized official

Name
Mr. Jonathan E Benn
Title
Manager
Phone
(518) 869-1717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 0101222R NY Primary

Addresses

Primary practice location

1873 Western Ave
Suite 200
Albany, NY 12203-5028

Mailing address

1873 Western Ave
Suite 200
Albany, NY 12203-5028
Phone (518) 869-1044

Other identifiers 1

IdentifierTypeStateIssuer
0101222ROtherNYFACILITY LICENSE

Other names 1

  • GHI Family Dental Practice/OEHC Doing business as

National Provider Directory

National Provider Directory

Locations

1873 Western Ave
Ste 200
Albany, NY 12203
Phone (518) 436-7815

Practitioners & affiliated clinicians

Practitioners 10

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": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1275823734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 WESTERN AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035028",
            "telephone_number": "518-869-1044",
            "fax_number": "518-869-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 WESTERN AVE",
            "address_2": "SUITE 200",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122035028",
            "telephone_number": "518-869-1044",
            "fax_number": "518-869-1965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBLEMHEALTH MEDICAL AND DENTAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "BENN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "518-869-1717",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "0101222R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "0101222R",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GHI Family Dental Practice/OEHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.