Provider Demographics
NPI:1922149962
Name:COORDINATED DENTAL, P.C.
Entity Type:Organization
Organization Name:COORDINATED DENTAL, P.C.
Other - Org Name:COORDINATED DENTAL SPECIALTIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:APPELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-888-3159
Mailing Address - Street 1:515 MADISON AVE
Mailing Address - Street 2:SUITE 1225
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5403
Mailing Address - Country:US
Mailing Address - Phone:212-888-3159
Mailing Address - Fax:
Practice Address - Street 1:515 MADISON AVE
Practice Address - Street 2:SUITE 1225
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5403
Practice Address - Country:US
Practice Address - Phone:212-888-3159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0500641223P0300X
NY0246081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty