Concourse Plaza Family Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

052071 Issued in NY

Legal business name

CONCOURSE PLAZA FAMILY DENTAL LLC

Practice address

230 E 161St St
Bronx, NY 10451-3546

Phone

(718) 992-8200

Fax

(718) 537-4169

NPI assigned

Sep 9, 2015

Last updated

Sep 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Godrick Allister Taylor, DDSNPI 1922261916

Title

Owner

Phone

(347) 204-3362

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Godrick Allister Taylor

  • General Practice Dentistry
  • Jackson Heights, NY
  • NPI 1922261916
  Authorized official Same address or phone
• Naresh Chandra Rastogi, D.D.S

  • General Practice Dentistry
  • Bronx, NY
  • NPI 1831302728
  NPD (past)

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1417325382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E 161ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513546",
            "telephone_number": "718-992-8200",
            "fax_number": "718-537-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E 161ST ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513546",
            "telephone_number": "718-992-8200",
            "fax_number": "718-537-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCOURSE PLAZA FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "GODRICK",
        "authorized_official_middle_name": "ALLISTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-204-3362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02677278",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Concourse Medical Center Inc
• Concourse Medical Office P C
• Concourse Pediatrics
• Concourse Pharmacy Inc.
• Concourse Plaza Dental Associates PC
• Concourse Rehab & Nursing Ctr Inc.
• Concourse Replacement LLC (Grand Concourse Dialysis Facility)
• Concourse Village Primary Care PLLC
• Concourse West Dental PLLC
• Concourse West Management Inc

• Dentist in Bronx, NY
• Providers in Bronx, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.