Advanced Dental Technologies Cor

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

029836-1 Issued in NY

Legal business name

ADVANCED DENTAL TECHNOLOGIES COR

Practice address

2983 Long Beach Rd
Oceanside, NY 11572-3204

Phone

(516) 536-5777

NPI assigned

Mar 30, 2015

Last updated

Jul 20, 2015By 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

John C Peterson, D.D.SNPI 1881703700

Title

President

Phone

(516) 536-5777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• John Conrad Peterson, D.D.S.

  • General Practice Dentistry
  • Oceanside, NY
  • NPI 1881703700
  Authorized official Same address or phone

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1679968408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2983 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723204",
            "telephone_number": "516-536-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2983 LONG BEACH RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115723204",
            "telephone_number": "516-536-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL TECHNOLOGIES COR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-536-5777",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "029836-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00304132",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben Accomando, PH.D
• Wray Sampson Adams
• Adept Inpatient Medical Services, PC (Oceanside Urgent Care)
• Joseph Albino Adipietro
• Taylor Trace Adler, RDN
• Sonia P Advani, MSED
• Elaine Lourdes Afanador-Pereira, LMSW
• Sazia Afrin
• Tayyaba Afzal
• Anubhav Agarwal, MD

• General Practice Dentistry in Oceanside, NY
• Providers in Oceanside, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.