Organization Active NPI

Tooth Fairy Endodontics, P.C.

  • Endodontics
  • Flushing, NY
National Provider Identifier
1497313241
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
TOOTH FAIRY ENDODONTICS, P.C.
Practice address
4125 Kissena Blvd Ste 117
Flushing, NY 11355-3150
Phone
(718) 321-9700
NPI assigned
Jun 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Authorized official

Name
Eugenia Yang, DMDNPI 1740545706
Title
Owner
Phone
(617) 571-1067

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

4125 Kissena Blvd Ste 117
Flushing, NY 11355-3150

Mailing address

4125 Kissena Blvd Ste 117
Flushing, NY 11355-3150
Phone (718) 321-9700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ug.yang@toothfairyendo.com Direct

National Provider Directory

National Provider Directory

Locations

4125 Kissena Blvd
Ste 117
Flushing, NY 11355
Phone (718) 321-9700

Practitioners & affiliated clinicians

Practitioners 2

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": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1497313241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 KISSENA BLVD STE 117",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553150",
            "telephone_number": "718-321-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 KISSENA BLVD STE 117",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113553150",
            "telephone_number": "718-321-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOTH FAIRY ENDODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-571-1067",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ug.yang@toothfairyendo.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4125 Kissena Blvd Ste 117",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113553150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.