125Th Street Dental Llp
LBN: 125Th Street Dental Llp
125Th Street Dental Llp is an health care organization with primary practice located at 437 W 125Th St , New York NY 10027-4201. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty.
125Th Street Dental Llp can be contacted via phone (646) 827-9819, or through Kopetskov, Serguei via phone (646) 827-9819.
Contact Information
Primary practice address
437 W 125Th St
New York NY 10027-4201
Phone: (646) 827-9819
Fax: (646) 827-0510
Website:
Authorized official contact:
Name: Kopetskov, Serguei Doctor of Dental Surgery (DDS)
Phone: (646) 827-9819
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 049097 | New York |
Profile Details
| NPI number | 1861523771 |
|---|---|
| LBN Legal business name | 125Th Street Dental Llp |
| DBA Doing business as | |
| Authorized official | Kopetskov, Serguei Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 9th, 2007 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861523771 | NPPES |
| New York | MEDICAID | 02772787 |
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