NPIMap

Organization Active NPI

Gentle Dentistry of Lancaster, PLLC

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1710488689
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GENTLE DENTISTRY OF LANCASTER, PLLC
Practice address
595 Madison Ave FL 27
New York, NY 10022-1649
Phone
(212) 758-9498
NPI assigned
Feb 26, 2018
Organization subpart
Yes
Parent organization
GENTLE DENTISTRY OF LANCASTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Authorized official

Name
Cassandra Petersen
Title
Credentialing Team Lead
Phone
(217) 540-8972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

595 Madison Ave FL 27
New York, NY 10022-1649

Mailing address

595 Madison Ave FL 27
New York, NY 10022-1649
Phone (212) 758-9498

Other names 1

  • EastSide Dental Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gentle Dentistry of Lancaster PLLC19 organizations share this tax ID, including this one
Part of
Gentle Dentistry of Lancaster PLLC

Other organizations with this tax ID 18

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

View all 18

Locations

595 Madison Ave
Fl 27
New York, NY 10022
Phone (212) 354-4830

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1710488689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 MADISON AVE FL 27",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221649",
            "telephone_number": "212-758-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 MADISON AVE FL 27",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221649",
            "telephone_number": "212-758-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE DENTISTRY OF LANCASTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENTLE DENTISTRY OF LANCASTER, PLLC",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8972"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EastSide Dental Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.