East Saffolk Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

0318241 Issued in NY

Legal business name

EAST SAFFOLK DENTAL PC

Practice address

1149 Old Country Road
Riverhead, NY 11901

Phone

(631) 369-7400

Fax

(631) 369-4214

NPI assigned

Mar 16, 2007

Last updated

Aug 22, 2020By 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

Steven M Goldberg, DDS

Title

Pres

Phone

(631) 369-7400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326162587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WEST MAIN STREET",
            "address_2": "SUITE 211",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-422-6066",
            "fax_number": "631-422-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 OLD COUNTRY ROAD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "11901",
            "telephone_number": "631-369-7400",
            "fax_number": "631-369-4214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SAFFOLK DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "631-369-7400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0318241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Riverhead, NY
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• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.