Provider Demographics
NPI:1609100262
Name:CONCERNED DENTAL CARE OF WESTCHESTER P.C.
Entity Type:Organization
Organization Name:CONCERNED DENTAL CARE OF WESTCHESTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FENSTERSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-337-5252
Mailing Address - Street 1:35 E GRASSY SPRAIN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-4620
Mailing Address - Country:US
Mailing Address - Phone:914-337-5252
Mailing Address - Fax:914-337-5426
Practice Address - Street 1:35 E GRASSY SPRAIN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4620
Practice Address - Country:US
Practice Address - Phone:914-337-5252
Practice Address - Fax:914-337-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty