Wyckoff Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

043062

Legal business name

WYCKOFF DENTAL PC

Practice address

321 Wyckoff Avenue
Ridgewood, NY 11385

Phone

(718) 386-3288

Fax

(718) 386-3540

NPI assigned

Feb 1, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Rufina Louis, DDS

Title

President

Phone

(718) 386-3288

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1861463366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 WYCKOFF AVENUE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-386-3288",
            "fax_number": "718-386-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 WYCKOFF AVENUE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11385",
            "telephone_number": "718-386-3288",
            "fax_number": "718-386-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCKOFF DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "LOUIS",
        "authorized_official_first_name": "RUFINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-386-3288",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": "043062",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": "02310121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01812615",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02310121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grzegorz Wolski, PT
• Woodbine Medical PC
• Maria Wronska, R.N.
• Richard Wu, O.D.
• Debra Wunder
• Wyckoff Physical Therapy PC.
• Xinyi TCM LLC (Food Therapy with Zoey)
• Yar Trading Corp (Pewex Pharmacy)
• Tristan Yarter, PT, DPT
• Yasik 2 Inc (Avonora pharmacy)

• Dentist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.