Park Avenue Dental Boutique, L.L.C.

Primary specialty

DentistTaxonomy code 122300000X

License

0506391 Issued in NY

Legal business name

PARK AVENUE DENTAL BOUTIQUE, L.L.C.

Practice address

104 E 74TH St
New York, NY 10021-3544

Phone

(212) 369-2202

NPI assigned

Mar 16, 2018

Last updated

Mar 16, 2018By 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

Mr. Michael Warszawski

Title

Secretary

Phone

(646) 455-8657

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolina Hakopian, DDS

  • General Practice Dentistry
  • New York, NY
  • NPI 1871160630
  NPD (past)

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1316440266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 74TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213544",
            "telephone_number": "212-369-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E 74TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213544",
            "telephone_number": "212-369-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE DENTAL BOUTIQUE, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "WARSZAWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "646-455-8657",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0506391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Comprehensive Dentistry, P.C.
• Park Avenue Comprehensive Medical
• Park Avenue Concierge Medicine PC
• Park Avenue Dental Anesthesia Services PC
• Park Avenue Dental Associates, P.C.
• Park Avenue Dental Group
• Park Avenue Dermatology & Plastic Surgery LLP
• Park Avenue Dermatology Associates, PC
• Park Avenue Dialysis Center LLC
• Park Avenue East Medical Suites PLLC

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.