NPIMap

Organization Active NPI

Prohealth Riverside Dental, PLLC

  • Dentist
  • Englewood Cliffs, NJ
National Provider Identifier
1295321107
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PROHEALTH RIVERSIDE DENTAL, PLLC
Practice address
300 Sylvan Ave FL 3
Englewood Cliffs, NJ 07632-2525
Phone
(201) 581-6300
NPI assigned
Dec 15, 2020
Organization subpart
Yes
Parent organization
PROHEALTH RIVERSIDE DENTAL, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Ms. Natalya Korobeynyk
Title
RCM
Phone
(516) 654-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

300 Sylvan Ave FL 3
Englewood Cliffs, NJ 07632-2525

Mailing address

3333 New Hyde Park Rd Ste 310
New Hyde Park, NY 11042-1205
Phone (516) 654-4400

National Provider Directory

National Provider Directory
Tax ID family
Prohealth Riverside Dental LLC5 organizations share this tax ID, including this one
Part of
Prohealth Riverside Dental LLC

Other organizations with this tax ID 4

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

Locations

300 Sylvan Ave
Fl 3
Englewood Cliffs, NJ 07632
Phone (201) 581-6300

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1295321107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 NEW HYDE PARK RD STE 310",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421205",
            "telephone_number": "516-654-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SYLVAN AVE FL 3",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322525",
            "telephone_number": "201-581-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH RIVERSIDE DENTAL, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROHEALTH RIVERSIDE DENTAL, PLLC",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "KOROBEYNYK",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "516-654-4400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.