Provider Demographics
NPI:1023453339
Name:209 NYC DENTAL LLP
Entity type:Organization
Organization Name:209 NYC DENTAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KAFKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-355-2290
Mailing Address - Street 1:209 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3705
Mailing Address - Country:US
Mailing Address - Phone:212-355-2290
Mailing Address - Fax:212-355-2379
Practice Address - Street 1:209 E 56TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3705
Practice Address - Country:US
Practice Address - Phone:212-355-2290
Practice Address - Fax:212-355-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1124045166OtherINDIVIDUAL NPI
NY1285981928OtherINDIVIDUAL NPI
NY1518947449OtherINDIVIDUAL NPI
NY1588684138OtherINDIVIDUAL NPI
NY1811918592OtherINDIVIDUAL NPI