NPIMap

Organization Active NPI

Allied Dental Care P.C.

  • General Practice Dentistry
  • Spring Valley, NY
National Provider Identifier
1790099844
Registry record updated Jul 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049884 Issued in NY
Legal business name
ALLIED DENTAL CARE P.C.
Practice address
375 W Route 59
Spring Valley, NY 10977-5339
Phone
(845) 352-5410
Fax
(845) 352-5412
NPI assigned
Jul 31, 2010
Last updated
Jul 31, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2010

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

Authorized official

Name
Dr. Yelena Nutskovsky, DMDNPI 1932154382
Title
President
Phone
(845) 352-5410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049884 NY Primary

Addresses

Primary practice location

375 W Route 59
Spring Valley, NY 10977-5339

Mailing address

375 W Route 59
Spring Valley, NY 10977-5339
Phone (845) 352-5410

Other identifiers 3

IdentifierTypeStateIssuer
02512861MedicaidNY
1932154382OtherNYPERSONAL NPI
9178018OtherNYFIDELIS ID

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, 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": "1280534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280534400000",
    "number": "1790099844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W ROUTE 59",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775339",
            "telephone_number": "845-352-5410",
            "fax_number": "845-352-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 W ROUTE 59",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775339",
            "telephone_number": "845-352-5410",
            "fax_number": "845-352-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-31",
        "last_updated": "2010-07-31",
        "status": "A",
        "authorized_official_last_name": "NUTSKOVSKY",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-352-5410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02512861",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1932154382",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS ID",
            "identifier": "9178018",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2010; 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.