Concerned Dental Care of Ronkonkoma, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

032077 Issued in NY

Legal business name

CONCERNED DENTAL CARE OF RONKONKOMA, PLLC

Practice address

966 Portion Road
Ronkonkoma, NY 11779

Phone

(631) 451-2245

NPI assigned

Jun 12, 2012

Last updated

Jun 12, 2012By 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. Jay Fensterstock, DDS

Title

President

Phone

(631) 451-2245

Specialties & licenses 1

Addresses

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.

• Melinda Kathleen Sheridan-Viquez, D.M.D.

  • General Practice Dentistry
  • Ronkonkoma, NY
  • NPI 1346452158
  NPD (past)
• Giuseppina Verde, DMD

  • General Practice Dentistry
  • Ronkonkoma, NY
  • NPI 1629319843
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339459200000",
    "number": "1700148103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 PORTION ROAD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "11779",
            "telephone_number": "631-451-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 PORTION ROAD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "11779",
            "telephone_number": "631-451-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERNED DENTAL CARE OF RONKONKOMA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A",
        "authorized_official_last_name": "FENSTERSTOCK",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-451-2245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "032077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Elaine Colchamiro-Smart, M.S.
• Kaitlyn Coleman, LMHC
• Meghan Collins
• Community Counseling Services (Ruth M Meyer)
• Complete Rehabilitation and Sports Physical Therapy, PC
• Connetquot Chiropractic (Ligament Laxity Analysis)
• Connetquot Chiropractic, PC
• Connetquot PT & Chiropractic PLLC (Connetquot PTDC)
• Yanique Constant I, RN
• Zafia N Cooper

• General Practice Dentistry in Ronkonkoma, NY
• Providers in Ronkonkoma, 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 Jun 12, 2012; 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.