Your Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

053599 Issued in NY

Legal business name

YOUR DENTAL, PC

Practice address

501 5TH Ave
Suite 703
New York, NY 10017-6107

Phone

(212) 682-5580

Fax

(212) 692-9355

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bryan B Ko, D.D.S.

Title

President

Phone

(212) 682-5580

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ki Wha Chang, D.D.S.

  • General Practice Dentistry
  • New York, NY
  • NPI 1467576579
  NPD (past)
• Jason Pang, D.D.S.

  • General Practice Dentistry
  • New York, NY
  • NPI 1447694765
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1457547846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 5TH AVE",
            "address_2": "SUITE 703",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176107",
            "telephone_number": "212-682-5580",
            "fax_number": "212-692-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE",
            "address_2": "SUITE 703",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176107",
            "telephone_number": "212-682-5580",
            "fax_number": "212-692-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-682-5580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.