Provider Demographics
NPI:1871727131
Name:TRIBECA DENTAL STUDIO
Entity type:Organization
Organization Name:TRIBECA DENTAL STUDIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLIER
Authorized Official - Prefix:
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-561-5303
Mailing Address - Street 1:54 WARREN ST
Mailing Address - Street 2:TRIBECA DENTAL STUDIO
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10007
Mailing Address - Country:US
Mailing Address - Phone:212-561-5303
Mailing Address - Fax:646-652-8190
Practice Address - Street 1:54 WARREN STREET
Practice Address - Street 2:TRIBECA DENTAL STUDIO
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10007
Practice Address - Country:US
Practice Address - Phone:212-561-5303
Practice Address - Fax:646-652-8190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIBECA DENTAL STUDIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051839-11223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY045045OtherORTHODONTIST
NY1093976292OtherORAL SURGEON
NY1477614162OtherPERIODONTIST
1144410010OtherPEDODONTIST
NY184443200-OtherPEDODONTIST
NY1861641698OtherPEDODONTIST
NY1821127580OtherENDODONTIST
NY1376782748OtherPROSTHODONTIST