Nyack Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

051032 Issued in NY

Legal business name

NYACK PEDIATRIC DENTISTRY

Practice address

265 North Highland Ave
Suite 101
Nyack, NY 10960

Phone

(845) 512-8434

Fax

(845) 512-8435

NPI assigned

Sep 3, 2008

Last updated

Sep 3, 2008By 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. Angela Boudounis-Hatzis, D.D.S.NPI 1134377260

Title

Cfo

Phone

(845) 812-8434

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Boudounis-Hatzis, D.D.S.

  • Pediatric Dentistry
  • Nyack, NY
  • NPI 1134377260
  NPD (past) Authorized official

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1598913626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 NORTH HIGHLAND AVE",
            "address_2": "SUITE 101",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-512-8434",
            "fax_number": "845-512-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 NORTH HIGHLAND AVE",
            "address_2": "SUITE 101",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "10960",
            "telephone_number": "845-512-8434",
            "fax_number": "845-512-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYACK PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "BOUDOUNIS-HATZIS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-812-8434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "051032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nyack Apothecary Inc (Koblin's Pharmacy)
• Nyack Community Ambulance Corps Inc
• Nyack Emergency Medical Association PLLC (Nyack Emergency Medical Associates)
• Nyack Integrated Medical Services, P.C.
• Nyack Medical Care, PC
• Nyack Pharmacy Inc
• Nyack Union Free School District
• Timothy O'Shea Jr., R.N.
• Kasey Marie Oliver, DNP
• Cierra Lytrice Osei-Buapim, LCSW

• Pediatric Dentistry in Nyack, NY
• Providers in Nyack, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.