Park Avenue Oral & Facial Surgery, P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

053655 Issued in NY

Legal business name

PARK AVENUE ORAL & FACIAL SURGERY, P.C.

Practice address

970 Park Ave
New York, NY 10028-0324

Phone

(212) 988-6725

Fax

(212) 988-6726

NPI assigned

Apr 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ruben Cohen, DDS

Title

President

Phone

(212) 988-6725

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1396061891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280324",
            "telephone_number": "212-988-6725",
            "fax_number": "212-988-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280324",
            "telephone_number": "212-988-6725",
            "fax_number": "212-988-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "491 Hampton Rd",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "NY",
            "postal_code": "119683004",
            "country_code": "US",
            "telephone_number": "212-988-6725",
            "fax_number": "212-988-6726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101281211",
            "country_code": "US",
            "telephone_number": "212-988-6725",
            "fax_number": "212-988-6726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARK AVENUE ORAL & FACIAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-988-6725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "053655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02922883",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Park Avenue Orthotics, Inc.
• Park Avenue Pediatrics of Manhattan, PC

• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.