4TH AVENUE DENTAL PC
NPI 1356580914
Dentist - General Practice in Mount Vernon, NY

Active since February 05, 2009
157 S 4TH AVE, MOUNT VERNON, NY 10550(914) 664-5342(718) 275-3049 Get Directions Write a Review

NPPES record last updated: February 5, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 4th Avenue Dental Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

4TH AVENUE DENTAL PC (NPI 1356580914) is a healthcare organization registered as a general practice in Mount Vernon, New York and active in the NPI registry since February 2009. The organization lists Haresh I Shah, President, as its authorized official.

NPPES Registry Identity

NPI1356580914
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business Name4TH AVENUE DENTAL PC
Location Address157 S 4TH AVEMount Vernon, NY 10550-3106
Mailing Address11033 64th AveForest Hills, NY 11375-1428 · (917) 886-4568 · Fax (718) 275-3049
Fax(718) 275-3049
Organization SubpartNo
Authorized OfficialHaresh I ShahPresident · (914) 664-5342
Enumeration DateFebruary 5, 2009
NPI 1356580914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in NY · 036630
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

157 S 4TH AVE, Mount Vernon, NY 10550

Other Identifiers 1

Medicaid00729819NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
157 S 4TH AVE
MOUNT VERNON, NY 10550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 4th Avenue Dental PC's NPI number?

The NPI number for 4th Avenue Dental PC is 1356580914. It was assigned to this organization in the NPPES registry on February 5, 2009.

Where is 4th Avenue Dental PC located?

4th Avenue Dental PC is located at 157 S 4th Ave, Mount Vernon, NY 10550. The listed phone number is (914) 664-5342.

What is 4th Avenue Dental PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for 4th Avenue Dental PC was last updated on February 5, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.