Organization Active NPI

Prestige Fifth Avenue Dental P C

  • Dentist
  • New York, NY
National Provider Identifier
1417317124
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PRESTIGE FIFTH AVENUE DENTAL P C
Practice address
110 E 40TH St RM 406
New York, NY 10016-1801
Phone
(212) 682-5060
Fax
(212) 683-4330
NPI assigned
Feb 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Yelena Simkha
Title
DDS
Phone
(212) 682-5060

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X

Addresses

Primary practice location

110 E 40TH St RM 406
New York, NY 10016-1801

Mailing address

110 E 40TH St RM 406
New York, NY 10016-1801
Phone (212) 682-5060

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1417317124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E 40TH ST RM 406",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161801",
            "telephone_number": "212-682-5060",
            "fax_number": "212-683-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 40TH ST RM 406",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161801",
            "telephone_number": "212-682-5060",
            "fax_number": "212-683-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE FIFTH AVENUE DENTAL P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "SIMKHA",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "212-682-5060"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.