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General NPI Number Information
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NPI Number | 1740717529
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Entity Type | Organization
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Legal Business Name | NEXT GENERATION DENTAL
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 5 W 71ST ST
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City | NEW YORK
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State | NY
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Zip | 10023-4198
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Country | US
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Telephone | 212-362-3360
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Fax | 212-202-4823
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Provider Business Mailing Address
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Address Line | 5 W 71ST ST
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City | NEW YORK
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State | NY
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Zip | 10023-4198
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Country | US
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Telephone | 212-362-3360
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Fax | 212-202-4823
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Authorized Official
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Title or Position | DR
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Name | DR. PAUL J GANJIAN
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Credential | DDS
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Telephone | 212-362-3360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 050559
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 056237
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 056734
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 058232
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 056023
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 054071
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0482791
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License Number State | NY
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