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BRONX RIVER DENTAL P.C. NPI 1336487131


NPI Information

NPI: 1336487131
Provider Name: BRONX RIVER DENTAL P.C.
Classification: Dental Therapist - 125J00000X
Entity Type: Organization
Address:
3000 BRONX PARK E
BRONX, NY
ZIP 10467
Phone: (718) 655-0075
Get Directions

BRONX RIVER DENTAL P.C. is a dental therapist in Bronx, NY. The provider is a Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. BRONX RIVER DENTAL P.C. NPI is 1336487131. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3000 BRONX PARK E
BRONX, NY
ZIP 10467-711
Phone: (718) 655-0075
Fax: (718) 708-6966

The provider's authorized official is Ezro Fattakhov .
The authorized official title is Doctor/owner and has the following contact phone number (718) 456-2626.

The enumeration date for this NPI number is 1/29/2013 and was last updated on 11/14/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1125J00000XDental Therapist046846NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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