US Dental Choice P.L.L.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

050642 Issued in NY

Legal business name

US DENTAL CHOICE P.L.L.C

Practice address

1963 Grand Concourse
Lower Level
Bronx, NY 10453-4994

Phone

(718) 294-8800

Fax

(718) 731-5100

NPI assigned

Mar 27, 2009

Organization subpart

No

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

Authorized official

Name

Aleksandr Izrailov

Title

Dentist/Owner

Phone

(718) 294-8800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238112000000",
    "number": "1639311319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 GRAND CONCOURSE",
            "address_2": "LOWER LEVEL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534994",
            "telephone_number": "718-294-8800",
            "fax_number": "718-731-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 GRAND CONCOURSE",
            "address_2": "LOWER LEVEL",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534994",
            "telephone_number": "718-294-8800",
            "fax_number": "718-731-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US DENTAL CHOICE P.L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A",
        "authorized_official_last_name": "IZRAILOV",
        "authorized_official_first_name": "ALEKSANDR",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "718-294-8800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "050642",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.