NPIMap

Organization Active NPI

Manhattan Boulevard Dental Associates, a Professional Corporation

Doing business as Today's Dental Cosmetic and Family Dentistry

  • General Practice Dentistry
  • Marietta, GA
National Provider Identifier
1750750360
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANHATTAN BOULEVARD DENTAL ASSOCIATES, A PROFESSIONAL CORPORATION
Doing business as
Today's Dental Cosmetic and Family Dentistry
Practice address
1090 Northchase Pkwy SE
Ste 150
Marietta, GA 30067-6405
Phone
(770) 916-5031
NPI assigned
Sep 24, 2015
Last updated
Sep 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Authorized official

Name
Dimetry Cossich, DDSNPI 1578681375
Title
President
Phone
(504) 361-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Pediatric Dentistry 1223P0221X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU

Addresses

Primary practice location

1090 Northchase Pkwy SE
Ste 150
Marietta, GA 30067-6405

Mailing address

1708 Manhattan Blvd
Suite C
Harvey, LA 70058-3400
Phone (504) 361-5333

Other names 1

  • Today's Dental Cosmetic and Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1708 Manhattan Blvd
Ste C
Harvey, LA 70058
Phone (504) 361-5333

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1750750360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 MANHATTAN BLVD",
            "address_2": "SUITE C",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700583400",
            "telephone_number": "504-361-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE",
            "address_2": "STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676405",
            "telephone_number": "770-916-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANHATTAN BOULEVARD DENTAL ASSOCIATES, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "COSSICH",
        "authorized_official_first_name": "DIMETRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-361-5333",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Today's Dental Cosmetic and Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; 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.