Provider Demographics
NPI:1447599584
Name:COINCIDENTAL
Entity Type:Organization
Organization Name:COINCIDENTAL
Other - Org Name:EL BARRIO DENTAL STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-369-0680
Mailing Address - Street 1:181 E 104TH ST
Mailing Address - Street 2:GROUND FLOOR DENTAL OFFICE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-8000
Mailing Address - Country:US
Mailing Address - Phone:212-369-0689
Mailing Address - Fax:212-369-0681
Practice Address - Street 1:181 E 104TH ST
Practice Address - Street 2:GROUND FLOOR DENTAL OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-8000
Practice Address - Country:US
Practice Address - Phone:212-369-0689
Practice Address - Fax:212-369-0681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-09
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0592381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty