NPIMap

Organization Active NPI

Columbia Univ Dental School

  • Dental Clinic/Center
  • New York, NY
National Provider Identifier
1730338369
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
COLUMBIA UNIV DENTAL SCHOOL
Practice address
622 W 168TH St
Vanderbilt Clinic 9TH Floor
New York, NY 10032-3720
Phone
(212) 305-5686
NPI assigned
Sep 18, 2008
Last updated
Sep 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Authorized official

Name
Dr. Ronnie Myers, DDS
Title
Associate Dean for Clinical Affairs
Phone
(212) 305-5686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

622 W 168TH St
Vanderbilt Clinic 9TH Floor
New York, NY 10032-3720

Mailing address

630 W 168TH St
P&S Box 30
New York, NY 10032-3725
Phone (212) 305-5686

Other identifiers 1

IdentifierTypeStateIssuer
00302034MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Steven M Roser25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

622 W 168th St
Fl 9
New York, NY 10032
Phone (212) 305-5686

630 W 168th St
Ste 30
New York, NY 10032

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221696000000",
    "number": "1730338369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "P&S BOX 30",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "address_2": "VANDERBILT CLINIC 9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA UNIV DENTAL SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "ASSOCIATE DEAN FOR CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "212-305-5686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00302034",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 18, 2008; 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.