Provider Demographics
NPI:1154442663
Name:CENTRAL PARK WEST DENTISTRTY, P.C.
Entity Type:Organization
Organization Name:CENTRAL PARK WEST DENTISTRTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LHOTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-579-8885
Mailing Address - Street 1:25 W 68TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5302
Mailing Address - Country:US
Mailing Address - Phone:212-579-8885
Mailing Address - Fax:212-579-8881
Practice Address - Street 1:25 W 68TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5302
Practice Address - Country:US
Practice Address - Phone:212-579-8885
Practice Address - Fax:212-579-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0403881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty