South Island Periodontics and Implantology PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

041914 Issued in NY

Legal business name

SOUTH ISLAND PERIODONTICS AND IMPLANTOLOGY PLLC

Practice address

657 Central Avenue
Cedarhurst, NY 11516

Phone

(516) 295-9566

Fax

(516) 706-7061

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Markus L Weitz, DDS

Title

Dentist

Phone

(516) 295-9566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1679697429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 CENTRAL AVENUE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "11516",
            "telephone_number": "516-295-9566",
            "fax_number": "516-706-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 CENTRAL AVENUE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "11516",
            "telephone_number": "516-295-9566",
            "fax_number": "516-706-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ISLAND PERIODONTICS AND IMPLANTOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "WEITZ",
        "authorized_official_first_name": "MARKUS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "516-295-9566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "041914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Cedarhurst, NY
• Providers in Cedarhurst, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.