Preetha a Kuruvilla DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048922 Issued in NY

Legal business name

PREETHA A KURUVILLA DDS PC

Practice address

260-12 Hillside Ave
Floral Park, NY 11004

Phone

(718) 347-8787

NPI assigned

Apr 19, 2013

Last updated

Apr 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Preetha A Kuruvilla, DDS

Title

President

Phone

(718) 347-8787

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1316381437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26012 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041745",
            "telephone_number": "718-347-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260-12 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "11004",
            "telephone_number": "718-347-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREETHA A KURUVILLA DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "KURUVILLA",
        "authorized_official_first_name": "PREETHA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-347-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02546129",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Floral Park, NY
• Providers in Floral Park, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.