Nyc Dental Group PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NYC DENTAL GROUP PLLC

Doing business as

DNTL

Practice address

401 76TH St Ste 1a
Brooklyn, NY 11209-3215

Phone

(347) 487-4888

Fax

(347) 524-6886

NPI assigned

Jan 15, 2019

Organization subpart

No

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

Authorized official

Name

Semyon Tilis, DDS

Title

President

Phone

(347) 487-4888

Specialties & licenses 1

Addresses

Other names 1

• DNTL Doing business as

Locations

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1598239493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 76TH ST STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093215",
            "telephone_number": "347-487-4888",
            "fax_number": "347-524-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 76TH ST STE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093215",
            "telephone_number": "347-487-4888",
            "fax_number": "347-524-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "TILIS",
        "authorized_official_first_name": "SEMYON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-487-4888",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DNTL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.