IDENTAL (NPI# 1326289695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326289695 |
| Entity Type | Organization |
| Organization Name | IDENTAL |
| Practice Address |
2600 South Rd Suite 21 A Poughkeepsie NY 12601-7003 |
| Practice Telephone | 8454374380 |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |
| Authorized Official Name | KARISSA PUCCI (VICE PRESIDENT) |
| Authorized Official Telephone | 8454374380 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245778935 | Idental | Dentist | 14902 Preston Rd Ste 401, Dallas, TX 75254-9132 | 2017-02-02 |
| 1508316753 | Idental | Dental Hygienist | 1320 S Green Bay Rd, Mount Pleasant, WI 53406-4402 | 2016-10-12 |
| 1265830947 | Idental | Dentist | 14902 Preston Rd, 401, Dallas, TX 75254-9191 | 2014-12-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | IDENTAL ASSOCIATES, LLC | 175 Mansfield Ave., Ste 9, Norton, MA 02766 |
| Virginia Business Entities | iDental Care PC | 4200 Poplar Branch Dr, Chantilly, Virginia 20151 |
| Indiana Business Entities | IDENTAL LAB, INC. | 701 Congressional Blvd, Ste 270, Carmel, IN 46032 |
| Street Address |
2600 SOUTH RD SUITE 21 A |
| City | POUGHKEEPSIE |
| State | NY |
| Zip Code | 12601-7003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033396098 | Leroy Kenneth Sheffer | Dentist | 2600 South Rd, Suite 21, Poughkeepsie, NY 12601-7003 | 2008-01-22 |
| 1437541810 | Brittney Carpenter | Licensed Practical Nurse | 2600 South Rd, Ste.44-125, Poughkeepsie, NY 12601-7003 | 2015-02-23 |
| 1588826739 | Dutchess County Dental Services | Dentist | 2600 South Rd, Suite 21, Poughkeepsie, NY 12601-7003 | 2008-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348425 | Hudson Valley Radiologists, PC | Radiology | 57 Kingwood Park, Poughkeepsie, NY 12601 | 2020-05-21 |
| 1063049088 | Jaquellah Taylor | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center 45 Reade Place, Poughkeepsie, NY 12601 | 2020-03-27 |
| 1053957050 | Jasmine Syin-lan Miller | Student in an Organized Health Care Education/Training Program | 3399 North Road, Marist College Msc 12617, Poughkeepsie, NY 12601 | 2019-11-25 |
| 1144864224 | Kim Beverly | Technician | 16 Tamidan Road, Poughkeepsle, NY 12601 | 2019-11-01 |
| 1851852768 | Marwa H Abdalla | Student in an Organized Health Care Education/Training Program | Vassar Brother Medical Center, 45 Reade Place, Poughkeepsie, NY 12601 | 2019-03-26 |
| 1619459047 | Victoria Bozydaj | Occupational Therapy Assistant | 50 Rinaldi Boulevard Apt 7r, Poughkeepsie, NY 12601 | 2018-09-01 |
| 1821589953 | Avo Gregory Serafino | Physician Assistant | 228 Donnelly, Poughkeepsie, NY 12601 | 2018-05-24 |
| 1649771486 | Raewyn Kalisha Clayton | Registered Nurse | 31 Forbus Street Apt C2, Poughkeepsie, NY 12601 | 2018-02-27 |
| 1780108761 | Ronica Dorothy White | Licensed Practical Nurse | 7c Muldowney Circle, Poughkeepsie, NY 12601 | 2017-08-01 |
| 1336662048 | Ashley Elizabeth Travers | Licensed Practical Nurse | 100 Innis Ave, Poughkeepsie, NY 12601 | 2017-07-25 |
| Find all providers in zip 12601 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154461689 | Bruce D Marzullo | Dentist | 43 Lagrange Avenue, Poughkeepsie, NY 12603 | 2007-02-07 |
| 1417051624 | Joseph M Prisco | Dentist | 29 Fox Street, Poughkeepsie, NY 12601 | 2006-09-08 |
| 1023021532 | Stanley Rudnicki | Dentist | 143 Hooker Ave, Poughkeepsie, NY 12601 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1235777566 | Asnis Dental Pllc | Dentist | 800 Woodbury Rd Ste C, Woodbury, NY 11797-2503 | 2019-12-17 |
| 1700420429 | Chavkin Oral and Maxillofacial Surgery LLC | Dentist | 414 Jericho Tpke Ste 2, New Hyde Park, NY 11040-4510 | 2019-11-06 |
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1750947792 | Eduard Munarov Dds PC | Dentist | 449 N State Rd Ste 102, Briarcliff Manor, NY 10510-1478 | 2019-05-15 |
| 1598227530 | Asnis Dental Pllc | Dentist | 250 Patchogue Yaphank Rd Ste 10, East Patchogue, NY 11772-4862 | 2019-04-01 |
| 1720545387 | Asnis Dental, Pllc | Dentist | 260 Middle Country Rd Ste 12, Selden, NY 11784-2570 | 2019-03-01 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1871006064 | Ny Oral and Maxillofacial Surgeon, PC | Dentist | 2844 Ocean Pkwy Ste B2, Brooklyn, NY 11235-7904 | 2017-11-09 |
| Find all providers with the same taxonomy | ||||
| City | POUGHKEEPSIE |
| Zip Code | 12601 |
Please comment or provide details below to improve the information on IDENTAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.