Provider Demographics
NPI:1083483549
Name:DENTAL DESIGN OF NEW YORK PC
Entity Type:Organization
Organization Name:DENTAL DESIGN OF NEW YORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATOUSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-449-5281
Mailing Address - Street 1:111 W 16TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6248
Mailing Address - Country:US
Mailing Address - Phone:240-449-5281
Mailing Address - Fax:
Practice Address - Street 1:5 HARRISON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2871
Practice Address - Country:US
Practice Address - Phone:240-449-5281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty