Staten Island Dental Boutique

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

STATEN ISLAND DENTAL BOUTIQUE

Practice address

1735 Richmond Ave FL 2
Staten Island, NY 10314-3907

Phone

(347) 596-7719

NPI assigned

Dec 16, 2022

Last updated

Dec 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Olena Ronan, DDSNPI 1144711755

Title

Owner

Phone

(347) 596-7719

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Olena Ronan, DDS

  • Dentist
  • Staten Island, NY
  • NPI 1144711755
  NPD Authorized official

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1770295255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 NARROWS RD N APT D",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052818",
            "telephone_number": "347-596-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 RICHMOND AVE FL 2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143907",
            "telephone_number": "347-596-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND DENTAL BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "RONAN",
        "authorized_official_first_name": "OLENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-596-7719",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staten Island Care Center
• Staten Island Center for Alternative Therapies, LLP
• Staten Island Center for Independent Living Inc.
• Staten Island Chiropractic & Sports Rehab P.C.
• Staten Island Chiropractic Associates, P.C. (Same)
• Staten Island Dentistry P.C.
• Staten Island Developmental Disabilities Services Office
• Staten Island Eyecare, LLC (Sterling Optical)
• Staten Island Faculty Medical Affiliates, University Faculty Practice
• Staten Island Faculty Medical Affiliates, University Faculty Practice

• Dental Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.