Provider Demographics
NPI:1942547476
Name:U.E.S. DENTAL P.L.L.C.
Entity Type:Organization
Organization Name:U.E.S. DENTAL P.L.L.C.
Other - Org Name:CENTRAL DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RATNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-496-2260
Mailing Address - Street 1:162 W 72ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3300
Mailing Address - Country:US
Mailing Address - Phone:212-496-2260
Mailing Address - Fax:
Practice Address - Street 1:162 W 72ND ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3300
Practice Address - Country:US
Practice Address - Phone:212-256-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02822246Medicaid