NPIMap

Organization Active NPI

Kids Dental Studio, PC

  • Pediatric Dentistry
  • Bayside, NY
National Provider Identifier
1386052173
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
047519 Issued in NY
Legal business name
KIDS DENTAL STUDIO, PC
Practice address
21154 45TH Dr
2ND Floor
Bayside, NY 11361-3310
Phone
(718) 428-3300
NPI assigned
Jul 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Authorized official

Name
Dr. Ken Chu, DDSNPI 1891998134
Title
President
Phone
(917) 607-1028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 047519 NY Primary

Addresses

Primary practice location

21154 45TH Dr
2ND Floor
Bayside, NY 11361-3310

Mailing address

19669 45TH Dr
Flushing, NY 11358-3509
Phone (718) 631-5515

National Provider Directory

National Provider Directory

Locations

21154 45th Dr
Ste 2
Bayside, NY 11361
Phone (718) 428-3300

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1386052173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19669 45TH DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113583509",
            "telephone_number": "718-631-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21154 45TH DR",
            "address_2": "2ND FLOOR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613310",
            "telephone_number": "718-428-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DENTAL STUDIO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-607-1028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "047519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.