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Contact Information

URBAN PEDIATRIC DENTAL PC
128 MOTT STREET
SUITE 203
NEW YORK, NY10013-5575
 Phone: 212-965-8113
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Exclusive Provider Organization

302F00000X
 

Health Maintenance Organization

302R00000X
Indicates primary specialty

NPI Profile & details for URBAN PEDIATRIC DENTAL PC

NPI Number 1699076083
LBN Legal business name URBAN PEDIATRIC DENTAL PC
Authorized official JESSICA MARN - (PRACTICE OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/16/2010
Last updated 01/24/2013 - About 13 years ago
Identifiers
NY License # 0497501
NY License # 0535941
NY Medicaid 02902734
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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