NPIMap

Organization Active NPI

Coliseum Dental East, PLLC

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1447927090
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLISEUM DENTAL EAST, PLLC
Practice address
244 W 54TH St Ste 614
New York, NY 10019-5515
Phone
(212) 757-3183
NPI assigned
Aug 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Authorized official

Name
Dr. Maia Berger, DDSNPI 1013053297
Title
President
Phone
(212) 757-3183

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

244 W 54TH St Ste 614
New York, NY 10019-5515

Mailing address

244 W 54TH St Ste 614
New York, NY 10019-5515
Phone (212) 757-3183

National Provider Directory

National Provider Directory

Locations

244 W 54th St
Ste 614
New York, NY 10019
Phone (212) 757-3183

Practitioners & affiliated clinicians

Practitioners 5

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": "1629676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629676800000",
    "number": "1447927090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 W 54TH ST STE 614",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195515",
            "telephone_number": "212-757-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 W 54TH ST STE 614",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195515",
            "telephone_number": "212-757-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM DENTAL EAST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "MAIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-757-3183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Aug 23, 2021; 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.