NPIMap

Organization Active NPI

Plaza Dental PC

  • Dentist
  • Farmingdale, NY
National Provider Identifier
1952508707
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
048957 Issued in NY
Legal business name
PLAZA DENTAL PC
Practice address
234 Airport Plaza Blvd
Suite 3
Farmingdale, NY 11735-3917
Phone
(631) 756-1900
Fax
(631) 756-1901
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Christopher M Perciballi, D.D.S.NPI 1003938994
Title
President
Phone
(631) 756-1900

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 048957 NY Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 050095 NY

Addresses

Primary practice location

234 Airport Plaza Blvd
Suite 3
Farmingdale, NY 11735-3917

Mailing address

234 Airport Plaza Blvd
Suite 3
Farmingdale, NY 11735-3917
Phone (631) 756-1900

National Provider Directory

National Provider Directory

Locations

234 Airport Plaza Blvd
Ste 3
Farmingdale, NY 11735
Phone (631) 756-1900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952508707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 AIRPORT PLAZA BLVD",
            "address_2": "SUITE 3",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353917",
            "telephone_number": "631-756-1900",
            "fax_number": "631-756-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 AIRPORT PLAZA BLVD",
            "address_2": "SUITE 3",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353917",
            "telephone_number": "631-756-1900",
            "fax_number": "631-756-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERCIBALLI",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-756-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "048957",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "050095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.