NPIMap

Organization Active NPI

Ny Metro Dental, PC

  • Dentist
  • Port Jefferson Station, NY
National Provider Identifier
1821622127
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NY METRO DENTAL, PC
Practice address
492 Old Town Rd
Port Jefferson Station, NY 11776-2249
Phone
(413) 382-7022
NPI assigned
Feb 25, 2020
Organization subpart
Yes
Parent organization
NY METRO DENTAL, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Authorized official

Name
Amy Cadieux
Title
Reg. MGR
Phone
(413) 382-7022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

492 Old Town Rd
Port Jefferson Station, NY 11776-2249

Mailing address

492 Old Town Rd
Port Jefferson Station, NY 11776-2249
Phone (413) 382-7022

Other names 1

  • Concerned Dental Care of Port Jefferson Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ny Metro Dental PC10 organizations share this tax ID, including this one
Part of
Ny Metro Dental PC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1821622127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762249",
            "telephone_number": "413-382-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762249",
            "telephone_number": "413-382-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY METRO DENTAL, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NY METRO DENTAL, PC",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "CADIEUX",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "REG. MGR",
        "authorized_official_telephone_number": "413-382-7022"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concerned Dental Care of Port Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.