Organization Active NPI

Michael J Collura, D.M.D., P.C.

  • Endodontics
  • New York, NY
National Provider Identifier
1346382579
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
049501-1 Issued in NY
Legal business name
MICHAEL J COLLURA, D.M.D., P.C.
Practice address
57 W 57TH St
Suite 1207
New York, NY 10019-2802
Phone
(212) 980-7857
Fax
(212) 980-7887
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carmen Beckford
Title
Office Manager
Phone
(212) 980-7857

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 049501-1 NY Primary

Addresses

Primary practice location

57 W 57TH St
Suite 1207
New York, NY 10019-2802

Mailing address

57 W 57TH St
Suite 1207
New York, NY 10019-2802
Phone (212) 980-7857

Other identifiers 1

IdentifierTypeStateIssuer
02579808MedicaidNY

National Provider Directory

National Provider Directory

Locations

57 W 57th St
Ste 1207
New York, NY 10019
Phone (212) 421-2131

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346382579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST",
            "address_2": "SUITE 1207",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "212-980-7857",
            "fax_number": "212-980-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W 57TH ST",
            "address_2": "SUITE 1207",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192802",
            "telephone_number": "212-980-7857",
            "fax_number": "212-980-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J COLLURA, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BECKFORD",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-980-7857"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "049501-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02579808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • 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.