Formoso Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

053083 Issued in NY

Legal business name

FORMOSO DENTAL PC

Practice address

30 E 40TH St RM 305
New York, NY 10016-1247

Phone

(212) 370-1919

NPI assigned

Jan 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. David Formosan Lee, DDSNPI 1003031402

Title

President

Phone

(718) 388-4613

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Formosan Lee, DDS

  • General Practice Dentistry
  • New York, NY
  • NPI 1003031402
  NPD Authorized official

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1629490826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 UNION AVE",
            "address_2": "D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112111739",
            "telephone_number": "718-388-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 40TH ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161247",
            "telephone_number": "212-370-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMOSO DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FORMOSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-388-4613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "053083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02907899",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aisha Z. Formentera, RN
• Silvia C. Formenti, M.D.
• Michael Pasquale Formica, PA
• Formosa Physical Therapy PC
• Victoria Rose Formosa, LMSW
• Christine Elisabeth Fornabia, PH.D.
• Candice Forness, REIKI MASTER TEACHER
• Monica N Fornier, MD
• Farzin Forooghian, MD
• Kamran Foroughi, DDS

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.