NPIMap

Organization Active NPI

Vida Dental Spa

  • Dentist
  • Whitestone, NY
National Provider Identifier
1588116347
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050794 Issued in NY
Legal business name
VIDA DENTAL SPA
Practice address
1101 154TH St
Whitestone, NY 11357-1954
Phone
(718) 475-6789
Fax
(718) 504-7500
NPI assigned
Oct 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Authorized official

Name
Maria Teresa Ioannou, DDS
Title
DDS
Phone
(718) 475-6789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 050794 NY Primary

Addresses

Primary practice location

1101 154TH St
Whitestone, NY 11357-1954

Mailing address

1101 154TH St
Whitestone, NY 11357-1954
Phone (718) 475-6789

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.

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1588116347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 154TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571954",
            "telephone_number": "718-475-6789",
            "fax_number": "718-504-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 154TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113571954",
            "telephone_number": "718-475-6789",
            "fax_number": "718-504-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDA DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "IOANNOU",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "718-475-6789",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; 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.