Organization Active NPI

Smile for You Dental PC

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1962549576
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SMILE FOR YOU DENTAL PC
Practice address
690 Bay Street
Staten Island, NY 10304-3830
Phone
(718) 727-3333
Fax
(718) 727-8321
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Mrs. Irina Zhidkova
Title
Office Manager
Phone
(718) 727-3333

Specialties & licenses 1

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

Addresses

Primary practice location

690 Bay Street
Staten Island, NY 10304-3830

Mailing address

690 Bay Street
Staten Island, NY 10304-3830
Phone (718) 727-3333

Other identifiers 1

IdentifierTypeStateIssuer
02617081MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1962549576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 BAY STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043830",
            "telephone_number": "718-727-3333",
            "fax_number": "718-727-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BAY STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103043830",
            "telephone_number": "718-727-3333",
            "fax_number": "718-727-8321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE FOR YOU DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "ZHIDKOVA",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-727-3333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02617081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.