Commack Pediatric Dental Assoc LLP

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

035281 Issued in NY

Legal business name

COMMACK PEDIATRIC DENTAL ASSOC LLP

Practice address

164 Commack Rd.
Ste 4
Commack, NY 11725

Phone

(631) 499-2112

Fax

(631) 858-0586

NPI assigned

Sep 18, 2008

Last updated

Sep 18, 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. Eric Gherman, DDS

Title

Dentist/Partner

Phone

(631) 499-2112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1598914236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 COMMACK RD.",
            "address_2": "STE 4",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-499-2112",
            "fax_number": "631-858-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 COMMACK RD.",
            "address_2": "STE 4",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "11725",
            "telephone_number": "631-499-2112",
            "fax_number": "631-858-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMACK PEDIATRIC DENTAL ASSOC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "GHERMAN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DENTIST/PARTNER",
        "authorized_official_telephone_number": "631-499-2112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "035281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Commack Dental Care PLLC (Your Smile Dental)
• Commack Dental Design PLLC
• Commack Drug and Surgical and Gifts (Final Pharmacy Inc)
• Commack Endodontics PC
• Commack Oral and Maxillofacial Surgeons PC
• Commack Pediatric Dentistry, P.C.
• Commack RX Pharmacy Inc (RX Express Pharmacy of Commack)
• Commack School District
• Commack School District
• Commack Speech & Language Disorders, PLLC

• Periodontics in Commack, NY
• Providers in Commack, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.