NPIMap

Organization Active NPI

Envision Dental Care PLLC

  • General Practice Dentistry
  • Putnam Valley, NY
National Provider Identifier
1518310374
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
056840 Issued in NY
Legal business name
ENVISION DENTAL CARE PLLC
Practice address
17 Oscawana Lake Rd
1St Floor
Putnam Valley, NY 10579-3003
Phone
(845) 528-2500
Fax
(845) 528-2502
NPI assigned
Jul 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Authorized official

Name
Dr. Rahul Pathak, DDSNPI 1023365863
Title
Owner
Phone
(845) 528-2500

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 056840 NY Primary

Addresses

Primary practice location

17 Oscawana Lake Rd
1St Floor
Putnam Valley, NY 10579-3003

Mailing address

17 Oscawana Lake Rd
PO Box 670
Putnam Valley, NY 10579-3003
Phone (845) 528-2500

Other names 1

  • Rockstar Dental PLLC Former legal business name

National Provider Directory

National Provider Directory

Locations

17 Oscawana Lake Rd
Fl 1
Putnam Valley, NY 10579
Phone (845) 528-2500

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": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1518310374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 OSCAWANA LAKE RD",
            "address_2": "PO BOX 670",
            "city": "PUTNAM VALLEY",
            "state": "NY",
            "postal_code": "105793003",
            "telephone_number": "845-528-2500",
            "fax_number": "845-528-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 OSCAWANA LAKE RD",
            "address_2": "1ST FLOOR",
            "city": "PUTNAM VALLEY",
            "state": "NY",
            "postal_code": "105793003",
            "telephone_number": "845-528-2500",
            "fax_number": "845-528-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "PATHAK",
        "authorized_official_first_name": "RAHUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-528-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockstar Dental PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Putnam Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.