Organization Active NPI

East Side Esda Inc D/B/a East Side Dental Arts

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1760155444
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EAST SIDE ESDA INC D/B/A EAST SIDE DENTAL ARTS
Practice address
225 E 70TH St Ste 1E
New York, NY 10021-5213
Phone
(212) 517-5940
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Dr. Mordecai Marc Liechtung, DMD
Title
Owner
Phone
(212) 247-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

225 E 70TH St Ste 1E
New York, NY 10021-5213

Mailing address

225 E 70TH St Ste 1E
New York, NY 10021-5213
Phone (212) 517-5940

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1760155444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 70TH ST STE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215213",
            "telephone_number": "212-517-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E 70TH ST STE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215213",
            "telephone_number": "212-517-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE ESDA INC D/B/A EAST SIDE DENTAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "LIECHTUNG",
        "authorized_official_first_name": "MORDECAI MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-247-2330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 28, 2021; 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.