Professional Oral Surgery Alliance of Downstate New York PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PROFESSIONAL ORAL SURGERY ALLIANCE OF DOWNSTATE NEW YORK PLLC

Practice address

1075 Central Park Ave
Suite 207
Scarsdale, NY 10583-3242

Phone

(914) 472-5252

Fax

(914) 722-5987

NPI assigned

Aug 13, 2008

Organization subpart

No

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

Authorized official

Name

Kayla Graham

Title

Credentialing

Phone

(724) 698-2474

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Tax ID family

Evan Chafitz DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Professional Oral Surgery Alliance of Downstate New York PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Scarsdale, NY
  • NPI 1144043092
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eunsu Jung

  • Oral and Maxillofacial Surgery (Dentist)
  • Baltimore, MD
  • NPI 1770962375

  NY

  Medicare reassignment NPD
• Jason Lee

  • Oral and Maxillofacial Surgery (Dentist)
  • Scarsdale, NY
  • NPI 1205398021
  Medicare reassignment

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1700032562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "724-698-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 CENTRAL PARK AVE",
            "address_2": "SUITE 207",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105833242",
            "telephone_number": "914-472-5252",
            "fax_number": "914-722-5987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORAL SURGERY ALLIANCE OF DOWNSTATE NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "724-698-2474"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pro Sports Physical Therapy of Westchester, PC
• Mary E Procidano, PH.D.
• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Oral Surgery Alliance of Downstate New York PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Scott M. Proscia Jr., B.S., ATC
• Pursuits of Progress LCSW, PLLC
• Mina Pyun, L.AC
• Zeshaan Qureshi, DPT

• Oral and Maxillofacial Surgery (Dentist) in Scarsdale, NY
• Providers in Scarsdale, 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 Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.