Ma Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

048018 Issued in NY

Legal business name

MA DENTAL PC

Practice address

295 Fort Washington Ave Apt C
New York, NY 10032-1210

Phone

(212) 781-4674

Fax

(212) 781-4675

NPI assigned

Apr 1, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Del Socorro Acosta, DDS

Title

Owner

Phone

(212) 781-4373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1790957637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 FORT WASHINGTON AVE APT C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321210",
            "telephone_number": "212-781-4674",
            "fax_number": "212-781-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 FORT WASHINGTON AVE APT C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321210",
            "telephone_number": "212-781-4674",
            "fax_number": "212-781-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "DEL SOCORRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-781-4373",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "048018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in New York, NY
• Providers in New York, 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 Apr 1, 2008; 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.