NPIMap

Organization Active NPI

Family Dentistry of Sullivan County, PLLC

  • Dentist
  • South Fallsburg, NY
National Provider Identifier
1912231556
Registry record updated Sep 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FAMILY DENTISTRY OF SULLIVAN COUNTY, PLLC
Practice address
5085 South Fallsburg Main St.
South Fallsburg, NY 12779
Phone
(845) 434-8444
Fax
(845) 434-8440
NPI assigned
Sep 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2009

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

Authorized official

Name
Mr. Nuchem Friedman
Title
Manager
Phone
(845) 774-9237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X NY Primary

Addresses

Primary practice location

5085 South Fallsburg Main St.
South Fallsburg, NY 12779

Mailing address

P.O. Box 2022
South Fallsburg, NY 12779
Phone (845) 434-8444

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1912231556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2022",
            "city": "SOUTH FALLSBURG",
            "state": "NY",
            "postal_code": "12779",
            "telephone_number": "845-434-8444",
            "fax_number": "845-434-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5085 SOUTH FALLSBURG MAIN ST.",
            "city": "SOUTH FALLSBURG",
            "state": "NY",
            "postal_code": "12779",
            "telephone_number": "845-434-8444",
            "fax_number": "845-434-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF SULLIVAN COUNTY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "NUCHEM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "845-774-9237",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Fallsburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; 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.