Ident Dental at Middletown

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

049967 Issued in NY

Legal business name

IDENT DENTAL AT MIDDLETOWN

Practice address

453 Route 211 E
Suite 103
Middletown, NY 10940-2206

Phone

(888) 433-6820

NPI assigned

May 12, 2009

Organization subpart

No

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

Authorized official

Name

Adam Sposato

Title

Administrator

Phone

(914) 245-4332

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1811121379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 ROUTE 211 E",
            "address_2": "SUITE 103",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402206",
            "telephone_number": "888-433-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 ROUTE 211 E",
            "address_2": "SUITE 103",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402206",
            "telephone_number": "888-433-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENT DENTAL AT MIDDLETOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "SPOSATO",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "914-245-4332"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "048328",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "049967",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "051732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inga Hyatt
• Cecelia Hylton
• Michele F Iannuzzi-Sucich, MD
• Cherif Ibrahim, MD
• Dina Ibrahim, DO
• Idp Middletown (Cornerstone Dental)
• Katherine L Idrovo, RN
• Charles Iglupas
• Augusta Ike
• Maria Ike

• Oral and Maxillofacial Pathology Dentistry in Middletown, NY
• Providers in Middletown, NY by specialty
• Oral and Maxillofacial Pathology Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.