NPIMap

Organization Active NPI

NYU College of Dentistry

  • Dental Clinic/Center
  • New York, NY
National Provider Identifier
1780804344
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
021314-2 Issued in NY
Legal business name
NYU COLLEGE OF DENTISTRY
Practice address
726 Broadway
Suite 350
New York, NY 10003-9502
Phone
(212) 443-1300
Fax
(212) 443-1331
NPI assigned
Apr 26, 2007
Last updated
Apr 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Authorized official

Name
Dr. Robert S Glickman, DDS
Title
Assoc Dean Clinical Affairs
Phone
(212) 443-1322

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Dental Clinic/Center 261QD0000X 021314-2 NY Primary

Addresses

Primary practice location

726 Broadway
Suite 350
New York, NY 10003-9502

Mailing address

726 Broadway
Suite 350
New York, NY 10003-9502
Phone (212) 443-1300

Other names 1

  • FACULTY PRACTICE SOUTH Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121002000667 NY Part B Supplier - Clinic/Group Practice 1355232422 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dr J Thomas Roland105 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

726 Broadway
Ste 350
New York, NY 10003
Phone (212) 443-1300

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1780804344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 BROADWAY",
            "address_2": "SUITE 350",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039502",
            "telephone_number": "212-443-1300",
            "fax_number": "212-443-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 BROADWAY",
            "address_2": "SUITE 350",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039502",
            "telephone_number": "212-443-1300",
            "fax_number": "212-443-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYU COLLEGE OF DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "GLICKMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSOC DEAN CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "212-443-1322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "021314-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FACULTY PRACTICE SOUTH",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FACULTY PRACTICE SOUTH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.