Provider Demographics
NPI:1689684458
Name:RYE DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RYE DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KABCENELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-967-1242
Mailing Address - Street 1:33 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2031
Mailing Address - Country:US
Mailing Address - Phone:914-967-1242
Mailing Address - Fax:914-967-8172
Practice Address - Street 1:33 CEDAR ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2031
Practice Address - Country:US
Practice Address - Phone:914-967-1242
Practice Address - Fax:914-967-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY447061223G0001X
NY366811223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty