New York Avenue Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NEW YORK AVENUE DENTAL

Practice address

3703 New York Ave
Union City, NJ 07087-4807

Phone

(201) 305-8800

Fax

(201) 305-8900

NPI assigned

Sep 24, 2009

Last updated

Sep 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fadi I Beydoun, D.M.D

Title

President

Phone

(201) 305-8800

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1588998405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 NEW YORK AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874807",
            "telephone_number": "201-305-8800",
            "fax_number": "201-305-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 NEW YORK AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874807",
            "telephone_number": "201-305-8800",
            "fax_number": "201-305-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK AVENUE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "BEYDOUN",
        "authorized_official_first_name": "FADI",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-305-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "19152",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0208540",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2009; 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.