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PINE STREET DENTAL ASSOCIATES P.C. NPI 1891761318


NPI Information

NPI: 1891761318
Provider Name: PINE STREET DENTAL ASSOCIATES, P.C.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 33D2289721

Address:
138 PINE ST
SUITE 210
KINGSTON, NY
ZIP 12401
Phone: (845) 338-6900
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PINE STREET DENTAL ASSOCIATES, P.C. is a general practice dentist in Kingston, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PINE STREET DENTAL ASSOCIATES, P.C. NPI is 1891761318. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

138 PINE ST
SUITE 210
KINGSTON, NY
ZIP 12401-947
Phone: (845) 338-6900
Fax: (845) 338-6013

The provider's authorized official is Charles Matthew Fliegler .
The authorized official title is Dentist, Owner and has the following contact phone number (845) 338-6900.

The CLIA number assigned to this NPI record is 33D2289721 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/24/2006 and was last updated on 9/10/2008.


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
11223G0001XDentistGeneral Practice032380NEW YORKNo
21223G0001XDentistGeneral Practice040046NEW YORKNo
31223G0001XDentistGeneral Practice0487491NEW YORKNo
41223G0001XDentistGeneral Practice038724NEW YORKNo
51223P0300XDentistPeriodontics044009NEW YORKNo
6122300000XDentist0526781NEW YORKNo
71223G0001XDentistGeneral Practice029231NEW YORKYes

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
1040046OTHERNEW YORKNYS DENTAL LICENSE
2038724OTHERNEW YORKNYS DENTAL LICENSE
30526781OTHERNEW YORKNYS DENTAL LICENSE
4044009OTHERNEW YORKNYS DENTAL LICENSE
5032380OTHERNEW YORKNYS DENTAL LICENSE
60487491OTHERNEW YORKNYS DENTAL LICENSE
7029231OTHERNEW YORKNYS DENTAL LICENSE

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.