Glick Dental Associate PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0550291 Issued in NY

Legal business name

GLICK DENTAL ASSOCIATE PLLC

Practice address

4250 Broadway Suite 5W
New York, NY 10033

Phone

(212) 795-0765

Fax

(212) 795-3600

NPI assigned

Mar 26, 2013

Organization subpart

No

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

Authorized official

Name

Mosha Glick

Title

President

Phone

(973) 865-2446

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Moshe Aaron Glick, DDS

  • Dentist
  • New York, NY
  • NPI 1710291620
  NPD (past)
• Christina Vourtsis, DDS

  • Dentist
  • New York, NY
  • NPI 1699084087
  NPD (past)

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1760724967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BROADWAY SUITE 5W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10033",
            "telephone_number": "212-795-0765",
            "fax_number": "212-795-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROADWAY SUITE 5W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10033",
            "telephone_number": "212-795-0765",
            "fax_number": "212-795-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLICK DENTAL ASSOCIATE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "GLICK",
        "authorized_official_first_name": "MOSHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-865-2446"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0550291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Glessner, RN
• Mikhail Gleyzer, D.O.
• Ilya G Glezerman, MD
• Angela M Gliatta
• Peter M Gliatto, MD
• Alexander F Glick, M.D.
• Anna Glick, D.D.S.
• Isabel Glick
• Jacqueline N. Glick, LCSW
• Jaimie Brooke Glick, MD

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.