125TH ST. DENTAL GROUP, PLLC (NPI# 1134561137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134561137 |
| Entity Type | Organization |
| Organization Name | 125TH ST. DENTAL GROUP, PLLC |
| Other Organization Name | 125 ST. BRACES |
| Practice Address |
63 W 125th St 2nd Floor New York NY 10027-4512 |
| Practice Telephone | 6465058852 |
| Mailing Telephone | 6465058852 |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-07-19 |
| Authorized Official Name | DR. DANIEL KUNCIO (MEMBER) |
| Authorized Official Telephone | 6465058852 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
051019 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03422386 | 05 | |
| NY | 01644504 | 05 | |
| NY | 03047216 | 05 |
| Other Name | Type Code |
|---|---|
| 125 St. Braces | Doing Business As Name - Organization |
| Street Address |
63 W 125TH ST 2ND FLOOR |
| City | NEW YORK |
| State | NY |
| Zip Code | 10027-4512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861890816 | Harlem 26 Dental Group Pllc | Dentist | 63 W 125th St, Second Floor, New York, NY 10027-4590 | 2014-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1720691199 | Mohamad El Zein | Student in an Organized Health Care Education/Training Program | 281 West 132nd Street, App Nb 2, New York, NY 10027 | 2020-08-26 |
| 1194335893 | Cynthia Wiggins | Social Worker | 1255 Amsterdam Avenue, New York, NY 10027 | 2020-08-06 |
| 1497399877 | Dr. F Sanchez Dental Arts Pllc | Dentist | 2 Saint Nicholas Terrace, Store #1, New York, NY 10027 | 2019-10-29 |
| 1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
| 1396216818 | Gissel Lopez | Licensed Practical Nurse | 119west 124th Street, New York, NY 10027 | 2018-12-10 |
| 1831660620 | Katherine Gonzalez | Licensed Practical Nurse | 119 121 W 124th Street, New York, NY 10027 | 2018-12-06 |
| 1003383456 | Ebony S Prescott | Specialist | 2130 Adam Clayton Powell Blvd, Phenix Salon Suites, Suite #114, Ny, NY 10027 | 2018-10-24 |
| 1619456589 | Arts of Optics Corp. | Optometrist | 200 W 125th St, New York, NY 10027 | 2018-08-10 |
| 1205355658 | Frederick Community Pharmacy Inc | Pharmacy | 2450 Frederick Douglas Blvd, New York, NY 10027 | 2017-09-18 |
| Find all providers in zip 10027 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1467069575 | Thomas P. Shannon, Dds, Professional Corporation | Dentist | 44 W 28th St Fl 14, New York, NY 10001-4212 | 2020-09-23 |
| 1871127209 | Parisa Zare | Dentist | 40 Waterside Plz Apt 23e, New York, NY 10010-2633 | 2020-02-25 |
| 1356999510 | Jin Sup Shin | Dentist | 133 E 58th St Ste 912, New York, NY 10022-1283 | 2019-08-30 |
| 1265095764 | Candid Michigan Pllc | Dentist | 41 Union Sq W Fl 2, New York, NY 10003-3235 | 2019-04-19 |
| 1699237149 | Joseph T Hung | Dentist | 630 5th Ave Ste 1812, New York, NY 10111-1876 | 2019-04-03 |
| 1265999411 | Asma Almaidhan | Dentist | 345 E 24th St # 6w, New York, NY 10010-4020 | 2019-02-25 |
| 1598221228 | Snk Orthodontics, Pllc | Dentist | 555 6th Ave, New York, NY 10011-2065 | 2019-02-19 |
| 1487131009 | South End Dental PC | Dentist | 375 S End Ave Ste 1b, New York, NY 10280-1014 | 2018-07-26 |
| 1669965679 | Elizabeth Eve | Dentist | 506 Lenox Ave Bldg K, New York, NY 10037-1802 | 2018-06-13 |
| Find all providers in NEW YORK | ||||
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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.