NPIMap

Organization Active NPI

Boss Dental P.C.

  • General Practice Dentistry
  • Flushing, NY
National Provider Identifier
1407062342
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
047068 Issued in NY
Legal business name
BOSS DENTAL P.C.
Practice address
3708 Main St # 4F
Flushing, NY 11354-6509
Phone
(646) 247-7367
NPI assigned
May 15, 2007
Organization subpart
Yes
Parent organization
BOSS DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Dr. Angela Lo, D.D.S.
Title
Dentist
Phone
(646) 247-7367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 047068 NY Primary

Addresses

Primary practice location

3708 Main St # 4F
Flushing, NY 11354-6509

Mailing address

1501 Avenue U
Brooklyn, NY 11229-3807
Phone (646) 247-7367

Other identifiers 1

IdentifierTypeStateIssuer
02618188MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Boss Dental6 organizations share this tax ID, including this one
Part of
Boss Dental

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1407062342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293807",
            "telephone_number": "646-247-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 MAIN ST # 4F",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546509",
            "telephone_number": "646-247-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSS DENTAL P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOSS DENTAL",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "646-247-7367",
        "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": "047068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02618188",
            "state": "NY"
        }
    ],
    "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 Mar 27, 2013; 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.