Dental Anesthesia of New York, LLC

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

054360 Issued in NY

Legal business name

DENTAL ANESTHESIA OF NEW YORK, LLC

Practice address

410 W 53Rd St Apt 126
New York, NY 10019-5693

Phone

(215) 527-8768

NPI assigned

Jun 16, 2016

Last updated

Jun 16, 2016By 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. Phong Ta, DDSNPI 1861646747

Title

Dentist Anesthesiologist/Owner

Phone

(215) 527-8768

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Phong Cam Ta, D.D.S.

  • Dental Anesthesiology
  • New York, NY
  • NPI 1861646747
  NPD (past) Authorized official

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1437509841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 53RD ST APT 126",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195693",
            "telephone_number": "215-527-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 53RD ST APT 126",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195693",
            "telephone_number": "215-527-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ANESTHESIA OF NEW YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "TA",
        "authorized_official_first_name": "PHONG",
        "authorized_official_title_or_position": "DENTIST ANESTHESIOLOGIST/OWNER",
        "authorized_official_telephone_number": "215-527-8768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NY",
            "license": "054360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03203894",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Denson
• Briar Lea Dent, M.D.
• Cedric Leon Dent Jr.
• Danielle Dent, BSN
• Katherine Ann Dent, M.D.
• Dental Artist, LLC (Gramercy Dental Group)
• Dental Artists LLC
• Dental Arts at Lexington & 63Rd St PC
• Dental Dental Services PLLC
• Dental Department of Mount Sinai

• Dental Anesthesiology in New York, NY
• Providers in New York, NY by specialty
• Dental Anesthesiology in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.