Guardian Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50-055536 Issued in NY

Legal business name

GUARDIAN DENTAL PLLC

Practice address

3682 Broadway FRNT 1
New York, NY 10031-1526

Phone

(917) 524-5622

NPI assigned

Jun 22, 2017

Organization subpart

No

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

Authorized official

Name

Jeremy Yoo, DDS

Title

President

Phone

(917) 524-5622

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982124798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3682 BROADWAY FRNT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100311526",
            "telephone_number": "917-524-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3682 BROADWAY FRNT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100311526",
            "telephone_number": "917-524-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-524-5622",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50-055536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03427369",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Guardado, MD
• Melanie Guardado, PA-C
• Gabriel Guardarramas, M.D.
• Joshua Guardia
• Majdal I Guardia, M.S. CCC-SLP
• Guardian Physical Therapy PC
• Karen Guardiola
• Nataly Sharom Guardiola
• Rohiverth Guarecuco, MD, PHD
• Carol Guariglia

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.