1871727131 NPI number — TRIBECA DENTAL STUDIO

Table of content: (NPI 1871727131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871727131 NPI number — TRIBECA DENTAL STUDIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIBECA DENTAL STUDIO
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:
Provider Other Organization Name Type Code:
6
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:
1871727131
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 WARREN ST
Provider Second Line Business Mailing Address:
TRIBECA DENTAL STUDIO
Provider Business Mailing Address City Name:
NYC
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-561-5303
Provider Business Mailing Address Fax Number:
646-652-8190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 WARREN STREET
Provider Second Line Business Practice Location Address:
TRIBECA DENTAL STUDIO
Provider Business Practice Location Address City Name:
NYC
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-561-5303
Provider Business Practice Location Address Fax Number:
646-652-8190
Provider Enumeration Date:
05/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KRIMAN
Authorized Official First Name:
INNA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLIER
Authorized Official Telephone Number:
212-561-5303

Provider Taxonomy Codes

  • Taxonomy code: 1223D0001X , with the licence number:  051839-1 , 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: 045045 . This is a "ORTHODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1093976292 . This is a "ORAL SURGEON" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1477614162 . This is a "PERIODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1144410010 . This is a "PEDODONTIST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 184443200- . This is a "PEDODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1861641698 . This is a "PEDODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1821127580 . This is a "ENDODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1376782748 . This is a "PROSTHODONTIST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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