Integrated Dental Design PLLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Legal business name

INTEGRATED DENTAL DESIGN PLLC

Practice address

17 Park Ave
New York, NY 10016-4324

Phone

(212) 213-1897

NPI assigned

May 3, 2019

Organization subpart

No

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

Authorized official

Name

Eleanor ReidNPI 1174732341

Title

Member

Phone

(319) 621-0415

Specialties & licenses 1

Addresses

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eleanor Lisa Reid, DMD

  • Prosthodontics
  • New York, NY
  • NPI 1174732341
  NPD Authorized official
• Lisa R Antonoff, D.D.S.

  • Prosthodontics
  • New York, NY
  • NPI 1457354417
  NPD (past)

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556841600000",
    "number": "1831754092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164324",
            "telephone_number": "212-213-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DENTAL DESIGN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-03",
        "last_updated": "2019-05-03",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "319-621-0415"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in New York, NY
• Prosthodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; 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.