Organization Active NPI

Plev BC PLC

Doing business as Aspen Dental

  • Dentist
  • East Syracuse, NY
National Provider Identifier
1730592163
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13084 Issued in MI
Legal business name
PLEV BC PLC
Doing business as
Aspen Dental
Practice address
6600 Weighlock Dr
East Syracuse, NY 13057
Phone
(866) 273-8204
Fax
(866) 803-4943
NPI assigned
Jun 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Jason Bertollini, PRS
Title
Provider Relations Specialist
Phone
(866) 273-8204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13084 MI Primary

Addresses

Primary practice location

6600 Weighlock Dr
East Syracuse, NY 13057

Mailing address

3505 Wilder Rd Ste a
Bay City, MI 48706-2173
Phone (989) 895-6600

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3505 Wilder Rd
Ste A
Bay City, MI 48706
Phone (989) 895-6600

6600 Weighlock Dr
East Syracuse, NY 13057

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1730592163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 WILDER RD STE A",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062173",
            "telephone_number": "989-895-6600",
            "fax_number": "989-671-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 WEIGHLOCK DR",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEV BC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SPECIALIST",
        "authorized_official_telephone_number": "866-273-8204",
        "authorized_official_credential": "PRS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.