NPIMap

Organization Active NPI

Illustradent Eastside Dental Services, PLLC

  • General Practice Dentistry
  • New York, NY
National Provider Identifier
1942463609
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052167 Issued in NY
Legal business name
ILLUSTRADENT EASTSIDE DENTAL SERVICES, PLLC
Practice address
810 2ND Ave
New York, NY 10017-4502
Phone
(212) 480-2111
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Alexander Joseph Pilavsky, DDSNPI 1164634549
Title
Owner
Phone
(212) 480-2111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 052167 NY Primary

Addresses

Primary practice location

810 2ND Ave
New York, NY 10017-4502

Mailing address

810 2ND Ave
New York, NY 10017-4502
Phone (212) 480-2111

National Provider Directory

National Provider Directory

Locations

810 2nd Ave
New York, NY 10017
Phone (212) 480-2111

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": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1942463609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174502",
            "telephone_number": "212-480-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174502",
            "telephone_number": "212-480-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUSTRADENT EASTSIDE DENTAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "PILAVSKY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-480-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

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