NPIMap

Organization Active NPI

Pediatric Dentistry of Nanuet PLLC

  • Pediatric Dentistry
  • Nanuet, NY
National Provider Identifier
1790219467
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
055623 Issued in NY
Legal business name
PEDIATRIC DENTISTRY OF NANUET PLLC
Practice address
55 Old Nyack Tpke
Suite 109
Nanuet, NY 10954-2461
Phone
(845) 507-0100
Fax
(845) 507-0110
NPI assigned
Apr 19, 2017
Last updated
Apr 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Authorized official

Name
Dr. Mayer Noskow, DDS
Title
Member
Phone
(845) 507-0100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 055773 NY
Pediatric Dentistry 1223P0221X 055623 NY Primary

Addresses

Primary practice location

55 Old Nyack Tpke
Suite 109
Nanuet, NY 10954-2461

Mailing address

55 Old Nyack Tpke
Suite 109
Nanuet, NY 10954-2461
Phone (845) 507-0100

National Provider Directory

National Provider Directory

Locations

55 Old Nyack Tpke
Ste 109
Nanuet, NY 10954
Phone (845) 507-0100

Practitioners & affiliated clinicians

Practitioners 3

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": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1790219467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OLD NYACK TPKE",
            "address_2": "SUITE 109",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-507-0100",
            "fax_number": "845-507-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OLD NYACK TPKE",
            "address_2": "SUITE 109",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "845-507-0100",
            "fax_number": "845-507-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF NANUET PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "NOSKOW",
        "authorized_official_first_name": "MAYER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "845-507-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055773",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.