NPIMap

Organization Active NPI

PM Dental Services PC

  • Dentist
  • Deer Park, NY
National Provider Identifier
1831361054
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
041974 Issued in NY
Legal business name
PM DENTAL SERVICES PC
Practice address
207 Bayshore Rd
Deer Park, NY 11729-6930
Phone
(631) 748-6136
NPI assigned
Mar 27, 2008
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Paul HennisNPI 1679562227
Title
Dentist
Phone
(718) 723-4878

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 037149 NY
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 041974 NY Primary

Addresses

Primary practice location

207 Bayshore Rd
Deer Park, NY 11729-6930

Mailing address

299 Candlewood Path
Dix Hills, NY 11746-8003
Phone (631) 748-6136

National Provider Directory

National Provider Directory
Tax ID family
PM Dental Services PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

207 Bay Shore Rd
Deer Park, NY 11729
Phone (631) 748-6136

Practitioners & affiliated clinicians

Practitioners 1

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": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1831361054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 CANDLEWOOD PATH",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468003",
            "telephone_number": "631-748-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 BAYSHORE RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296930",
            "telephone_number": "631-748-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM DENTAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "HENNIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-723-4878"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "037149",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "041974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.