Healthcare Provider Details

I. General information

NPI: 1811412174
Provider Name (Legal Business Name): ALLEN & SCHWARZ DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CENTRAL PARK S RM 10B
NEW YORK NY
10019-1628
US

IV. Provider business mailing address

30 CENTRAL PARK S RM 10B
NEW YORK NY
10019-1628
US

V. Phone/Fax

Practice location:
  • Phone: 212-753-3450
  • Fax: 212-319-5272
Mailing address:
  • Phone: 212-753-3450
  • Fax: 212-319-5272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number050942-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number030107-1
License Number StateNY

VIII. Authorized Official

Name: DR. KENNETH ALLEN
Title or Position: MEMBER
Credential: DDS
Phone: 212-753-3450