Organization Active NPI

Arden Dental PC

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1578898177
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ARDEN DENTAL PC
Practice address
337 Hampton Green
Staten Island, NY 10312-0000
Phone
(718) 948-0870
NPI assigned
Oct 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Valery Dubovikov, DDS
Title
DDS/Owner
Phone
(718) 948-0870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

337 Hampton Green
Staten Island, NY 10312-0000

Mailing address

337 Hampton Green
Staten Island, NY 10312-0000

Other identifiers 1

IdentifierTypeStateIssuer
02355737MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1578898177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 HAMPTON GREEN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103120000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 HAMPTON GREEN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103120000",
            "telephone_number": "718-948-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDEN DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "DUBOVIKOV",
        "authorized_official_first_name": "VALERY",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "718-948-0870",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02355737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.