Provider Demographics
NPI:1952686073
Name:ATLAS PARK DENTAL, P.C.
Entity Type:Organization
Organization Name:ATLAS PARK DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-894-2110
Mailing Address - Street 1:8028 COOPER AVE
Mailing Address - Street 2:BUILDING 6 SUITE 207
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7711
Mailing Address - Country:US
Mailing Address - Phone:718-894-2110
Mailing Address - Fax:
Practice Address - Street 1:8028 COOPER AVE
Practice Address - Street 2:BUILDING 6 SUITE 207
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7711
Practice Address - Country:US
Practice Address - Phone:718-894-2110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0488891223G0001X
NY0543071223G0001X
NY0544851223G0001X
NY0555001223G0001X
NY0491051223P0221X
NY0555141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1215221874OtherNPI
NY1710118948OtherNPI
NY1811138233OtherNPI
NY1639473929OtherNPI
NY1689896300OtherNPI
NY1891778957OtherNPI