Harlem 26 Dental Group PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

HARLEM 26 DENTAL GROUP PLLC

Practice address

63 W 125TH St
Second Floor
New York, NY 10027-4590

Phone

(212) 348-3600

Fax

(212) 348-3900

NPI assigned

Dec 8, 2014

Organization subpart

No

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

Authorized official

Name

Alicia A Pitkouvich

Title

Manager

Phone

(917) 391-8000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1861890816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 W 125TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274590",
            "telephone_number": "212-348-3600",
            "fax_number": "212-348-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 W 125TH ST",
            "address_2": "SECOND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274590",
            "telephone_number": "212-348-3600",
            "fax_number": "212-348-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARLEM 26 DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "PITKOUVICH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-391-8000"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in New York, NY
• Providers in New York, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.