Cambria Dentistry PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

051063 Issued in NY

Legal business name

CAMBRIA DENTISTRY PLLC

Practice address

219-11 Linden Boulevard
Cambria Heights, NY 11411

Phone

(718) 257-0300

NPI assigned

Nov 25, 2015

Organization subpart

No

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

Authorized official

Name

Koorosh Shamtoub, DDS

Title

Owner

Phone

(718) 257-0300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1568836724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219-11 LINDEN BOULEVARD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "11411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219-11 LINDEN BOULEVARD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "11411",
            "telephone_number": "718-257-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIA DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "SHAMTOUB",
        "authorized_official_first_name": "KOOROSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-257-0300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "051063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Cambria Heights, NY
• Providers in Cambria Heights, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.