Vervedent Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

047934-1 Issued in NY

Legal business name

VERVEDENT DENTAL PC

Practice address

13987 35TH Ave
L2
Flushing, NY 11354-3548

Phone

(718) 961-0528

Fax

(718) 961-4538

NPI assigned

Jun 30, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Danny Lo, DDS

Title

Owner

Phone

(718) 961-0528

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1407207459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13987 35TH AVE",
            "address_2": "L2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543548",
            "telephone_number": "718-961-0528",
            "fax_number": "718-961-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13987 35TH AVE",
            "address_2": "L2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543548",
            "telephone_number": "718-961-0528",
            "fax_number": "718-961-4538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERVEDENT DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-961-0528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047934-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04216359",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Flushing, NY
• Providers in Flushing, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.