Provider Demographics
NPI:1801067715
Name:ALL IN ONE DENTAL
Entity type:Organization
Organization Name:ALL IN ONE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:WENDY
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-220-2030
Mailing Address - Street 1:4521 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-220-2030
Mailing Address - Fax:718-220-2032
Practice Address - Street 1:4521 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-1515
Practice Address - Country:US
Practice Address - Phone:718-220-2030
Practice Address - Fax:718-220-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047607261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02339480Medicaid