Pethan Tin, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

052227 Issued in NY

Practice address

1940 Grand Concourse
Bronx, NY 10457-5221

Phone

(718) 583-6347

Fax

(718) 583-8047

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bartley R. Labiner,DDS

  dba Dr.Bartley R. Labiner

  • Oral and Maxillofacial Surgery (Dentist)
  • Bronx, NY
  • NPI 1851506505
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669428041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 86TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244021",
            "telephone_number": "917-714-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104575221",
            "telephone_number": "718-583-6347",
            "fax_number": "718-583-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIN",
        "first_name": "PETHAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Teresa Timoney, C.N.M.
• Catrice Timothy
• Chanet Timothy
• Justin Timperio
• Eleanor Thayer Timreck, C.N.M
• Valoren Tinaj, DDS
• Fatou Agnes Tine, MD
• Gabriella Nicole Tinelli
• Andry Tineo
• Jaharia Tineo

• Oral and Maxillofacial Surgery (Dentist) in Bronx, NY
• Providers in Bronx, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.