Corona Family Dental Assoc PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CORONA FAMILY DENTAL ASSOC PC

Doing business as

Corona Family Dental Center

Practice address

3766 Junction Boulevard
Corona, NY 11368

Phone

(718) 898-1300

Fax

(718) 533-8644

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward J Sutton, DDS

Title

Pres

Phone

(718) 645-3000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Corona Family Dental Center Doing business as

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841389046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 OCEAN PARKWAY",
            "address_2": "1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11223",
            "telephone_number": "718-645-3000",
            "fax_number": "718-645-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3766 JUNCTION BOULEVARD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-898-1300",
            "fax_number": "718-533-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA FAMILY DENTAL ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "718-645-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02419670",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Corona, NY
• Providers in Corona, NY by specialty
• Dentist 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.