Beth J. Dorfman, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

049011 Issued in NY

Practice address

Park Avenue Periodontal Associates
532 Park Avenue
New York, NY 10021

Phone

(212) 838-0940

Fax

(212) 355-4784

NPI assigned

May 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710192901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PARK AVENUE PERIODONTAL ASSOCIATES",
            "address_2": "532 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-838-0940",
            "fax_number": "212-355-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PARK AVENUE PERIODONTAL ASSOCIATES",
            "address_2": "532 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-838-0940",
            "fax_number": "212-355-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORFMAN",
        "first_name": "BETH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "049011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "133049463",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martine Dorelien, CRNA
• Karin Dorell, M.D.
• Alison Dorfman, LCSW
• Alla Dorfman, D.D.S
• Ava Dorfman, PH.D.
• Beth Nitzberg Dorfman, M.S.S.W., L.C.S.W.
• Brittany Victoria Dorfman, MA, BCBA. LBA
• Dana Dorfman, MSW, PHD
• David Dorfman, PH.D.
• Eliana Dorfman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.