GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C. (NPI# 1710246533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710246533 |
Entity Type | Organization |
Organization Name | GOTHAM ORAL & MAXILLOFACIAL SURGERY P.C. |
Practice Address |
563 E Tremont Ave Bronx NY 10457-4655 |
Practice Telephone | 7184664500 |
Practice Fax Number | 9177928502 |
Mailing Telephone | 7184664500 |
Mailing Fax Number | 9177928502 |
Enumeration Date | 2012-05-14 |
Last Update Date | 2012-05-14 |
Authorized Official Name | DR. ELEFTHERIOS GAVRIIL (PRESIDENT) |
Authorized Official Telephone | 7184664500 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
053186 | NY | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 03399171 | 05 |
Street Address |
563 E TREMONT AVE |
City | BRONX |
State | NY |
Zip Code | 10457-4655 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093947673 | Ganesh Inapakolla | Pharmacist | 563 E Tremont Ave, Bronx, NY 10457-4655 | 2009-08-17 |
1336652593 | Tremont Smiles Dental PC | Dentist | 563 E Tremont Ave, Bronx, NY 10457-4655 | 2017-11-09 |
1902215429 | Ericka Buyco | Dentist | 563 E Tremont Ave, Bronx, NY 10457-4655 | 2014-08-08 |
1083950893 | Tremont Social Garden,inc | Clinic/Center | 563 E Tremont Ave, 2nd Floor, Bronx, NY 10457-4655 | 2012-12-26 |
1942569538 | Tremont Medical Services, P.C. | Internal Medicine | 563 E Tremont Ave, Bronx, NY 10457-4655 | 2012-05-16 |
1306112560 | Zen Dental P.C. | Dentist | 563 E Tremont Ave, Bronx, NY 10457-4655 | 2012-03-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346851722 | Aruna Muthumanickam | Student in an Organized Health Care Education/Training Program | 1650 Grand Concourse, The Bronx, New York City, NY 10457 | 2020-08-11 |
1013527753 | Cherine Awad | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue, Bronxcare Health System, Bronx, NY 10457 | 2020-08-07 |
1023626926 | Tolulope Oyinlola Olorunsogo | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue - Bronxcare Health System, Departmen, Suite 6h, Bronx, NY 10457 | 2020-07-16 |
1750999801 | Kalyan C Chilukuri | Student in an Organized Health Care Education/Training Program | Bronxcare Hospital Center, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-15 |
1003434457 | Nauri Estefani Abreu Roa | Student in an Organized Health Care Education/Training Program | Bronxlebanon Health System, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-13 |
1033737630 | Sapna Sharma | Student in an Organized Health Care Education/Training Program | St. Barnabas Hospital, 4422 Third Avenue Bronx, Bronx, NY 10457 | 2020-07-09 |
1194341081 | Asha Tadepalli | Optometrist | 1650 Selwyn Avenue, Suite 1c, Bronxcare Health System, Department of Ophthalmology, Bronx, NY 10457 | 2020-06-17 |
1578196549 | Ernesto Murray | Technician | 463 East 178st Apt#3b, Bronx New York, NY 10457 | 2020-02-19 |
1245891001 | Muhammad Shahzad | Student in an Organized Health Care Education/Training Program | St. Barnabas Health 4422 Third Avenue, Bronx, NY 10457 | 2019-06-24 |
1144886565 | Grant Joseph Gleason | Student in an Organized Health Care Education/Training Program | 4422 3rd Avenue St Barbabas Hospital Dept of Dentistry, Bronx, NY 10457 | 2019-05-10 |
Find all providers in zip 10457 |
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 |
---|---|---|---|---|
1538551296 | Bronx Oral Surgery, PC | Dentist | 355 E 149th St Rm 206, Bronx, NY 10455-3909 | 2015-03-04 |
1598192569 | Hanuman Oral Surgery Pllc | Dentist | 2070 Grand Concourse, Bronx, NY 10457-2837 | 2013-10-04 |
1689804569 | Katherine Kyoung-jin Lee | Dentist | 1210 Lakewood Pl, Bronx, NY 10461-1816 | 2009-07-25 |
1528201613 | Manhattan Oral Facial Surgery LLC | Dentist | 6118 Riverdale Ave, Bronx, NY 10471-1009 | 2009-04-20 |
1568517431 | Mohammad Kazem Sadeghi | Dentist | 3370 Baychester Ave, Bronx, NY 10475-1565 | 2007-01-23 |
1184781791 | Riverdale Oral & Maxillofacial Surgery PC | Dentist | 3333 Henry Hudson Pky, Suite 9, Bronx, NY 10463-3236 | 2007-01-02 |
1043396930 | Lawrence Steven Holtzman | Dentist | 1250 Waters Pl Ste 503, Bronx, NY 10461-2732 | 2006-10-31 |
1780684373 | Bartley R. Labiner | Dentist | 1940 Grand Concourse, Bronx, NY 10457-5221 | 2005-07-26 |
1033115506 | Paul Gates | Dentist | 1770 Grand Concourse, Bronx, NY 10457-5524 | 2005-06-21 |
1760485247 | Mauricio Wiltz | Dentist | 3332 Rochambeau Avenue, Department of Dentistry, 2nd Floor, Bronx, NY 10467-2836 | 2005-05-27 |
Find all providers in BRONX |
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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.