Provider Demographics
NPI:1124395033
Name:RIVSON DENTAL PC
Entity Type:Organization
Organization Name:RIVSON DENTAL PC
Other - Org Name:NYC DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEINKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-861-3070
Mailing Address - Street 1:216 E 39TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2738
Mailing Address - Country:US
Mailing Address - Phone:646-861-3070
Mailing Address - Fax:646-861-2980
Practice Address - Street 1:216 E 39TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2738
Practice Address - Country:US
Practice Address - Phone:646-861-3070
Practice Address - Fax:646-861-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty