4290 Washington Heights Dental

Primary specialty

DentistTaxonomy code 122300000X

License

049809 Issued in NY

Legal business name

4290 WASHINGTON HEIGHTS DENTAL

Practice address

4290 Broadway # 2S
New York, NY 10033-3732

Phone

(212) 781-0166

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Moise Nawlo, DDS

Title

Partner

Phone

(212) 780-0166

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1649424045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 BROADWAY # 2S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333732",
            "telephone_number": "212-781-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 BROADWAY # 2S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333732",
            "telephone_number": "212-781-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4290 WASHINGTON HEIGHTS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "NAWLO",
        "authorized_official_first_name": "MOISE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "212-780-0166",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "049809",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 11, 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.