Organization Active NPI

Family Choice Dental Care P.C.

  • Dentist
  • Ridgewood, NY
National Provider Identifier
1639448327
Registry record updated Dec 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
046932 Issued in NY
Legal business name
FAMILY CHOICE DENTAL CARE P.C.
Practice address
6622 Fresh Pond Rd
Ridgewood, NY 11385-3305
Phone
(718) 576-3371
Fax
(718) 576-3381
NPI assigned
Dec 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 25, 2011

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

Authorized official

Name
Dr. Samih A Attia, D.M.D.
Title
President
Phone
(718) 576-3371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 046932 NY Primary

Addresses

Primary practice location

6622 Fresh Pond Rd
Ridgewood, NY 11385-3305

Mailing address

6622 Fresh Pond Rd
Ridgewood, NY 11385-3305
Phone (718) 576-3371

Other identifiers 1

IdentifierTypeStateIssuer
0239086MedicaidNY

National Provider Directory

National Provider Directory

Locations

6622 Fresh Pond Rd
Ridgewood, NY 11385
Phone (516) 457-4539

NPI Registry JSON

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

{
    "created_epoch": "1324771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324771200000",
    "number": "1639448327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6622 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853305",
            "telephone_number": "718-576-3371",
            "fax_number": "718-576-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113853305",
            "telephone_number": "718-576-3371",
            "fax_number": "718-576-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHOICE DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-25",
        "last_updated": "2011-12-25",
        "status": "A",
        "authorized_official_last_name": "ATTIA",
        "authorized_official_first_name": "SAMIH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-576-3371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0239086",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2011; 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.