Astoria General Dentistry, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048615 Issued in NY

Legal business name

ASTORIA GENERAL DENTISTRY, P.C.

Practice address

3018 31St Ave
Astoria, NY 11106-2405

Phone

(718) 545-7046

Fax

(715) 545-2606

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wanda E Mejia, DDS

Title

Owner

Phone

(718) 545-7046

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801097795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3018 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062405",
            "telephone_number": "718-545-7046",
            "fax_number": "715-545-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 31ST AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111062405",
            "telephone_number": "718-545-7046",
            "fax_number": "715-545-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTORIA GENERAL DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-545-7046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02166109",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL SECURITY NUMBER",
            "identifier": "$$$$$$$$$",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Astoria Foot and Ankle Surgery
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• Astoria Healthcare Associates LLP
• Astoria Kids Dental, P.C.
• Astoria Kool Smile Dental PC
• Astoria Medical Arts P.C.
• Astoria Medical of New York, LLC

• General Practice Dentistry in Astoria, NY
• Providers in Astoria, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.