Prudent Dental Care,P.C

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

051064 Issued in NY

Legal business name

PRUDENT DENTAL CARE,P.C

Practice address

7517 41St Ave
Elmhurst, NY 11373-1004

Phone

(718) 803-6300

Fax

(718) 803-2434

NPI assigned

Sep 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mysore Sanathkumar Ganga, D.D.S

Title

President

Phone

(718) 803-6300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1992013973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7517 41ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731004",
            "telephone_number": "718-803-6300",
            "fax_number": "718-803-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7517 41ST AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731004",
            "telephone_number": "718-803-6300",
            "fax_number": "718-803-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENT DENTAL CARE,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "GANGA",
        "authorized_official_first_name": "MYSORE",
        "authorized_official_middle_name": "SANATHKUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-803-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02489976",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.