Healthcare Provider Details

I. General information

NPI: 1215893094
Provider Name (Legal Business Name): AH NYC DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E FORDHAM RD
BRONX NY
10458-5049
US

IV. Provider business mailing address

625 E FORDHAM RD
BRONX NY
10458-5049
US

V. Phone/Fax

Practice location:
  • Phone: 212-960-8767
  • Fax:
Mailing address:
  • Phone: 212-960-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDER HEIFITZ
Title or Position: DENTIST - ORAL AND MAXILLOFACIAL SU
Credential: DDS, GD
Phone: 212-960-8767