Pediatric Dentistry & West Side Orthodontics, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY & WEST SIDE ORTHODONTICS, LLC

Practice address

327 Central Park W Ste 1C
New York, NY 10025-7631

Phone

(212) 280-1700

NPI assigned

Aug 27, 2024

Organization subpart

No

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

Authorized official

Name

Jenny Garcia-Rocha

Title

Sr Credentialing Team Lead

Phone

(972) 869-3789

Specialties & licenses 1

Addresses

Other names 1

• Central Park West Pediatric Dentistry Doing business as

Practitioners 3

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

• Alexis Leigh Cohen, DDS, MPH

  • Pediatric Dentistry
  • New York, NY
  • NPI 1245674472
  NPD
• Mary Eve Maestre, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New York, NY
  • NPI 1366659112
  NPD (past)
• Robert Peracchia, DDS

  • Pediatric Dentistry
  • New York, NY
  • NPI 1659444008
  NPD (past)

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1497589071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CENTRAL PARK W STE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 CENTRAL PARK W STE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100257631",
            "telephone_number": "212-280-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY & WEST SIDE ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "GARCIA-ROCHA",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "SR CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "972-869-3789"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Park West Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krisanne Jean Pederson, DPT
• Pediatric and Adolescent Medicine
• Pediatric and Young Adult Psychological Services of New York
• Pediatric Associates of Nyc
• Pediatric Dental Associates
• Pediatric Dentistry on Park PLLC
• Pediatric Developmental Services, Inc.
• Pediatric Head and Neck Associates, PC
• Pediatric Head and Neck Associates, PC
• Pediatric Head and Neck Associates, PC

• Pediatric Dentistry in New York, NY
• Providers in New York, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.