123 Dental Group PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

055884 Issued in NY

Legal business name

123 DENTAL GROUP PC

Doing business as

123 Dental Group

Practice address

123 E 37TH St
Suite 1C
New York, NY 10016-3030

Phone

(212) 686-1115

Fax

(212) 686-1142

NPI assigned

Apr 10, 2014

Last updated

Apr 10, 2014By 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

Hyo-Jin Kim, DDS

Title

President

Phone

(212) 686-1115

Specialties & licenses 1

Addresses

Other names 1

• 123 Dental Group Doing business as

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1851710511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E 37TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163030",
            "telephone_number": "212-686-1115",
            "fax_number": "212-686-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E 37TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163030",
            "telephone_number": "212-686-1115",
            "fax_number": "212-686-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "123 DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HYO-JIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-686-1115",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "055884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "123 Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.