Austin 26 Dental Group PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

054245 Issued in NY

Legal business name

AUSTIN 26 DENTAL GROUP PLLC

Practice address

7017 Austin St
3Rd Floor
Forest Hills, NY 11375-4875

Phone

(718) 261-4000

Fax

(718) 228-8886

NPI assigned

Jul 17, 2014

Organization subpart

No

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

Authorized official

Name

Alicia A Pitkouvich

Title

Manager

Phone

(917) 391-8000

Specialties & licenses 1

Addresses

Other names 1

• Austin Street Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405814400000",
    "number": "1972910255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7017 AUSTIN ST",
            "address_2": "3RD FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754875",
            "telephone_number": "718-261-4000",
            "fax_number": "718-228-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7017 AUSTIN ST",
            "address_2": "3RD FLOOR",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754875",
            "telephone_number": "718-261-4000",
            "fax_number": "718-228-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN 26 DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-20",
        "status": "A",
        "authorized_official_last_name": "PITKOUVICH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-391-8000"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "054245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Street Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2014; 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.