NPIMap

Organization Active NPI

Manhattan Dentistry Cosmety

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1639417801
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050317-1 Issued in NY
Legal business name
MANHATTAN DENTISTRY COSMETY
Practice address
461 Fort Washington Ave Apt 1
New York, NY 10033-4632
Phone
(212) 568-1003
Fax
(212) 568-5715
NPI assigned
Jan 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Authorized official

Name
Ibelka VargasNPI 1548465594
Title
Owner
Phone
(212) 568-1003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 050317-1 NY Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 052543 NY

Addresses

Primary practice location

461 Fort Washington Ave Apt 1
New York, NY 10033-4632

Mailing address

461 Fort Washington Ave Apt 1
New York, NY 10033-4632
Phone (212) 568-1003

Other identifiers 2

IdentifierTypeStateIssuer
2711071MedicaidNY
2329808MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1639417801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 FORT WASHINGTON AVE APT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334632",
            "telephone_number": "212-568-1003",
            "fax_number": "212-568-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 FORT WASHINGTON AVE APT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334632",
            "telephone_number": "212-568-1003",
            "fax_number": "212-568-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN DENTISTRY COSMETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "IBELKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-568-1003"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050317-1",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2711071",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2329808",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.