GREAT SMILE DENTAL SERVICES PC NPI 1275919656

NPI Information

NPI: 1275919656
Provider Name: GREAT SMILE DENTAL SERVICES PC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
629 W 185TH ST
4TH FLOOR
NEW YORK, NY
ZIP 10033
Phone: (212) 795-9519
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GREAT SMILE DENTAL SERVICES PC is a customized equipment durable medical equipment medical supplies in New York, NY. GREAT SMILE DENTAL SERVICES PC NPI is 1275919656. The provider is registered as an organization entity type.

The provider's business location address is:

629 W 185TH ST
4TH FLOOR
NEW YORK, NY
ZIP 10033-102
Phone: (212) 795-9519
Fax: (646) 353-6482

The provider's authorized official is Franklin L Martinez .
The authorized official title is President and has the following contact phone number (212) 795-9519.

The enumeration date for this NPI number is 8/7/2015 and was last updated on 8/7/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	050561-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02387915	MEDICAID	NEW YORK

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

NPI Synchronization or Removal

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