NPIMap

Organization Active NPI

Albany Upstate Dental PC

  • Dentist
  • Albany, NY
National Provider Identifier
1457772931
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050817 Issued in NY
Legal business name
ALBANY UPSTATE DENTAL PC
Practice address
540 Broadway
100
Albany, NY 12207-2708
Phone
(518) 465-0808
Fax
(518) 465-1450
NPI assigned
Dec 30, 2013
Last updated
Dec 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Authorized official

Name
Dr. Tariq Pasha Malik, DDSNPI 1811906563
Title
Owner / Dentist
Phone
(518) 465-0808

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 050817 NY Primary

Addresses

Primary practice location

540 Broadway
100
Albany, NY 12207-2708

Mailing address

540 Broadway
100
Albany, NY 12207-2708
Phone (518) 465-0808

Other identifiers 1

IdentifierTypeStateIssuer
1811906563OtherNYSOLE PROPERITER NPI

National Provider Directory

National Provider Directory

Locations

540 Broadway
Ste 100
Albany, NY 12207
Phone (518) 465-0808

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1457772931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 BROADWAY",
            "address_2": "100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072708",
            "telephone_number": "518-465-0808",
            "fax_number": "518-465-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BROADWAY",
            "address_2": "100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072708",
            "telephone_number": "518-465-0808",
            "fax_number": "518-465-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY UPSTATE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-30",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "TARIQ",
        "authorized_official_middle_name": "PASHA",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "518-465-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLE PROPERITER NPI",
            "identifier": "1811906563",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.