Great Smile Dental Services PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

050561-1 Issued in NY

Legal business name

GREAT SMILE DENTAL SERVICES PC

Practice address

629 W 185TH St
4TH Floor
New York, NY 10033-3102

Phone

(212) 795-9519

Fax

(646) 353-6482

NPI assigned

Aug 7, 2015

Organization subpart

No

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

Authorized official

Name

Franklin L Martinez, DDS

Title

President

Phone

(212) 795-9519

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Great Smile Dental Services LLC2 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.

• Great Smile Dental Services, LLC

  • General Practice Dentistry
  • New York, NY
  • NPI 1083952378
  NPD tax ID

Locations

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1275919656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W 185TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333102",
            "telephone_number": "212-795-9519",
            "fax_number": "646-353-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W 185TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333102",
            "telephone_number": "212-795-9519",
            "fax_number": "646-353-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SMILE DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-795-9519",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NY",
            "license": "050561-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02387915",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Great Plains Behavioral Health Services, P.a.
• Great Smile Dental Services, LLC
• Great Tiger Acupuncture, P.C.
• Great Wall Medical, P.C.
• Greatcare Fi LLC
• Greatcare Inc

• Customized Equipment (DME) in New York, NY
• Providers in New York, NY by specialty
• Customized Equipment (DME) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.