Provider Demographics
NPI:1639435290
Name:ACCESS DENTAL GROUP MANHATTAN PLLC
Entity Type:Organization
Organization Name:ACCESS DENTAL GROUP MANHATTAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-240-0028
Mailing Address - Street 1:139 CENTRE ST
Mailing Address - Street 2:#322
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4552
Mailing Address - Country:US
Mailing Address - Phone:212-240-0028
Mailing Address - Fax:212-240-0035
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:#322
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4552
Practice Address - Country:US
Practice Address - Phone:212-240-0028
Practice Address - Fax:212-240-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0530081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty