Mott Street Dental P.C

Primary specialty

DentistTaxonomy code 122300000X

License

049014 Issued in NY

Legal business name

MOTT STREET DENTAL P.C

Practice address

2 Mott St RM 303
New York, NY 10013-5003

Phone

(212) 732-5875

NPI assigned

May 21, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ivy X. Wang, D.D.SNPI 1720078769

Title

President

Phone

(212) 732-5875

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ivy X Wang, D.D.S

  • General Practice Dentistry
  • New York, NY
  • NPI 1720078769
  NPD (past) Authorized official
• Jung Hyen Kim, DDS

  • Dentist
  • New York, NY
  • NPI 1134679632
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679781611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MOTT ST RM 303",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MOTT ST RM 303",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135003",
            "telephone_number": "212-732-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTT STREET DENTAL P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "IVY",
        "authorized_official_middle_name": "X.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-732-5875",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02758381",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rajeev S Motiwala, M.D.
• Jay A Motola, MD
• Catherine Motosko, MD
• Mott Adult Day Care Center Corp
• Mott St Pharmacy
• Mott Street Optical Inc. (mott street opical inc.)
• Mott Women Healthcare PLLC
• John Mott, M.D.
• Dahlia Lauren Mottahedeh, PSY.D.
• Camille Motte Dit Falisse, RD

• 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 Aug 22, 2020; 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.