NPIMap

Organization Active NPI

Glad Dental P.C.

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1548558836
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
055422-1 Issued in NY
Legal business name
GLAD DENTAL P.C.
Practice address
293 E 149TH St
Bronx, NY 10451-5601
Phone
(646) 404-5005
Fax
(646) 404-5006
NPI assigned
Jul 20, 2011
Last updated
Jul 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Dr. Lia Datikashvili, D.D.S.NPI 1780977926
Title
President
Phone
(646) 404-5005

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)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 055422-1 NY Primary

Addresses

Primary practice location

293 E 149TH St
Bronx, NY 10451-5601

Mailing address

293 E 149TH St
Bronx, NY 10451-5601
Phone (646) 404-5005

National Provider Directory

National Provider Directory

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1548558836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515601",
            "telephone_number": "646-404-5005",
            "fax_number": "646-404-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 E 149TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515601",
            "telephone_number": "646-404-5005",
            "fax_number": "646-404-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAD DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "DATIKASHVILI",
        "authorized_official_first_name": "LIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-404-5005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055422-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.