Integrated Aesthetic Dentistry, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

INTEGRATED AESTHETIC DENTISTRY, PLLC

Practice address

130 E 18TH St
1M
New York, NY 10003-2416

Phone

(212) 254-5454

NPI assigned

Dec 29, 2016

Organization subpart

No

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

Authorized official

Name

Caroline Barsoum, D.M.D.

Title

Dentist

Phone

(212) 254-5454

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1508301516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 18TH ST",
            "address_2": "1M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 18TH ST",
            "address_2": "1M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032416",
            "telephone_number": "212-254-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED AESTHETIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "BARSOUM",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "212-254-5454",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in New York, NY
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.