NPIMap

Organization Active NPI

Four Seasons Dental Care

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1386812501
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050303 Issued in NY
Legal business name
FOUR SEASONS DENTAL CARE
Practice address
14340 38TH Ave
102
Flushing, NY 11354-5759
Phone
(718) 762-3361
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Dr. Chongmin Park, D.D.S.
Title
President
Phone
(718) 762-3361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 050303 NY Primary

Addresses

Primary practice location

14340 38TH Ave
102
Flushing, NY 11354-5759

Mailing address

14340 38TH Ave
102
Flushing, NY 11354-5759
Phone (718) 762-3361

National Provider Directory

National Provider Directory

Locations

14340 38th Ave
Ste 102
Flushing, NY 11354
Phone (718) 762-3361

Practitioners & affiliated clinicians

Practitioners 1

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": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1386812501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14340 38TH AVE",
            "address_2": "102",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545759",
            "telephone_number": "718-762-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14340 38TH AVE",
            "address_2": "102",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545759",
            "telephone_number": "718-762-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHONGMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-762-3361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.