Active NPI
Juan Collado, DDS PC
- General Practice Dentistry
- New York, NY
National Provider Identifier
1518172113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 045828-1
- Legal business name
- JUAN COLLADO, DDS PC
- Practice address
- 520 W 190TH St
Suite a
New York, NY 10040-3407 - Phone
- (212) 568-3231
- Fax
- (212) 568-7727
- NPI assigned
- May 14, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Juan Pablo Collado, D.D.S.
- Title
- President
- Phone
- (212) 568-3231
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 045828-1 | NY | Primary |
Addresses
Primary practice location
520 W 190TH St
Suite a
New York, NY 10040-3407
Mailing address
365 Rockledge PL
Private House
Teaneck, NJ 07666-4014
Phone (212) 568-3231
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02752707 | Medicaid | NY |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Dentist
- New York, NY
- NPI 1952390015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1518172113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 ROCKLEDGE PL",
"address_2": "PRIVATE HOUSE",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664014",
"telephone_number": "212-568-3231",
"fax_number": "212-568-7727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 W 190TH ST",
"address_2": "SUITE A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100403407",
"telephone_number": "212-568-3231",
"fax_number": "212-568-7727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JUAN COLLADO, DDS PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "COLLADO",
"authorized_official_first_name": "JUAN",
"authorized_official_middle_name": "PABLO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "212-568-3231",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "045828-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02752707",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.