1831203199 NPI number — A & H DENTAL

Table of content: (NPI 1831203199)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831203199 NPI number — A & H DENTAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & H DENTAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PLATINUM DENTAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831203199
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 BROADWAY
Provider Second Line Business Mailing Address:
SUITE 408
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10006-2546
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-430-3888
Provider Business Mailing Address Fax Number:
212-430-3889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65 BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 408 A & H DENTAL DBA PLATINUM DENTAL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10006-2546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-430-3888
Provider Business Practice Location Address Fax Number:
212-430-3889
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HEIFITZ
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST OWNER
Authorized Official Telephone Number:
212-430-3888

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  0471301 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0471301 . This is a "LIC" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com