NPIMap

Organization Active NPI

St Marks Dental PC

  • Dentist
  • Staten Island, NY
National Provider Identifier
1407866841
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041072 Issued in NY
Legal business name
ST MARKS DENTAL PC
Practice address
418 St Mark'S Place
St Mark'S Dental
Staten Island, NY 10301
Phone
(718) 720-6836
Fax
(718) 720-6996
NPI assigned
Aug 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Authorized official

Name
Dr. Mark Salvatore Genco, DMDNPI 1508228131
Title
Dentist
Phone
(718) 720-6836

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 041072 NY Primary

Addresses

Primary practice location

418 St Mark'S Place
St Mark'S Dental
Staten Island, NY 10301

Mailing address

418 St Mark'S Place
St Mark'S Dental
Staten Island, NY 10301
Phone (718) 720-6836

Other identifiers 1

IdentifierTypeStateIssuer
01103644MedicaidNY

Other names 1

  • St Marks Dental Office Other name

National Provider Directory

National Provider Directory

Locations

418 Saint Marks Pl
Staten Island, NY 10301
Phone (718) 720-6836

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1407866841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 ST MARK'S PLACE",
            "address_2": "ST MARK'S DENTAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-720-6836",
            "fax_number": "718-720-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 ST MARK'S PLACE",
            "address_2": "ST MARK'S DENTAL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-720-6836",
            "fax_number": "718-720-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARKS DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "GENCO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "SALVATORE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-720-6836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "041072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01103644",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Marks Dental Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.