New Image Dental,PC

Primary specialty

DentistTaxonomy code 122300000X

License

050874 Issued in NY

Legal business name

NEW IMAGE DENTAL,PC

Practice address

341 Saint Nicholas Ave
#3
Ridgewood, NY 11385-2759

Phone

(347) 844-9797

Fax

(347) 844-9798

NPI assigned

Feb 16, 2012

Organization subpart

No

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

Authorized official

Name

Fernando Cordero

Title

President

Phone

(347) 844-9797

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1508139973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 SAINT NICHOLAS AVE",
            "address_2": "#3",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852759",
            "telephone_number": "347-844-9797",
            "fax_number": "347-844-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 SAINT NICHOLAS AVE",
            "address_2": "#3",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113852759",
            "telephone_number": "347-844-9797",
            "fax_number": "347-844-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGE DENTAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "CORDERO",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-844-9797"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.