Greenburgh Kids Dental, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

GREENBURGH KIDS DENTAL, PC

Practice address

99 Fieldstone Dr
Hartsdale, NY 10530-1564

Phone

(914) 997-8820

Fax

(914) 997-9627

NPI assigned

Aug 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Kim, DDS

Title

Owner

Phone

(562) 405-2001

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1851946271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 FIELDSTONE DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301564",
            "telephone_number": "914-997-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 FIELDSTONE DR",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301564",
            "telephone_number": "914-997-8820",
            "fax_number": "914-997-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBURGH KIDS DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-405-2001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03260895",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.primarycaredental.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "99 Fieldstone Dr",
            "city": "Hartsdale",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105301564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Anne Marie Gorski-Makar
• Nicole Goudreau-Green, LCSW-R
• Rosario Gonzalez Gould, M.A.
• Paul J. Greco, D.M.D.
• Greenburgh Central School District No. 7
• Hayley Groglio, DDS
• Narda Grover, RD
• Binghui Faye Guan-Elkin, L.AC.
• Guerrino Dentistry of Hartsdale, PC
• Dennis Gulle

• Pediatric Dentistry in Hartsdale, NY
• Providers in Hartsdale, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.