Renaissance Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

052174 Issued in NY

Legal business name

RENAISSANCE DENTAL PC

Practice address

4 Normanskill Blvd
Delmar, NY 12054-1335

Phone

(518) 261-4800

NPI assigned

Sep 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Marina Shraga, DDS

Title

President

Phone

(518) 261-4800

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Albany County Dental Associates Doing business as

Locations

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1457729337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NORMANSKILL BLVD",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541335",
            "telephone_number": "518-261-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 NORMANSKILL BLVD",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541335",
            "telephone_number": "518-261-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "SHRAGA",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-261-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "052174",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052174",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02721117",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albany County Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Purcell
• Robert R Quimby, M.D.
• Kayla Rackowski, PT
• Ellen Regal, NP
• Christopher R Reilly, L.AC.
• Judy Park Revai, OD
• Rebecca May Rice, DACM, L.AC.
• Jeanne-Marie Rimlinger, PSYD., LMHC
• Robert K. Heineman Jr., MD PC
• Robert T Giombetti

• Dentist in Delmar, NY
• Providers in Delmar, 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 22, 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.