DC Dental, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

045810-1 Issued in NY

Legal business name

DC DENTAL, PLLC

Practice address

454 Fort Washington Ave
Suite 5
New York, NY 10033-4650

Phone

(212) 923-5568

Fax

(212) 923-5568

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Damaris A Cordero, DDS

Title

Owner/President

Phone

(212) 923-5568

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1932372315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 FORT WASHINGTON AVE",
            "address_2": "SUITE 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334650",
            "telephone_number": "212-923-5568",
            "fax_number": "212-923-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 FORT WASHINGTON AVE",
            "address_2": "SUITE 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100334650",
            "telephone_number": "212-923-5568",
            "fax_number": "212-923-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "CORDERO",
        "authorized_official_first_name": "DAMARIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "212-923-5568",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "045810-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01544421",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0016322",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Daza
• DB Dermatology PLLC
• DB LCSW PLLC
• DBN Drugs Inc (Farmacia San Nicholas)
• DBT Skills Training Program
• Dcapex LLC
• DCW Providers (Il) P.L.L.C.
• DCW Providers NJ PC
• DCW Providers, P.a.
• DCW Providers, P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.