MADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC
NPI 1700179124
Dentist - Oral and Maxillofacial Surgery in New York, NY

Q: What is Madison Avenue Oral Surgery And Implant Center, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since May 18, 2011

295 MADISON AVE FL 28, NEW YORK, NY 10017(212) 660-0305 Get Directions Write a Review

NPPES record last updated: July 9, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Madison Avenue Oral Surgery And Implant Center, Pc NPPES

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

MADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC (NPI 1700179124) is a healthcare organization registered as an oral and maxillofacial surgery in New York, New York and active in the NPI registry since May 2011. The organization maintains a secondary practice location in Staten Island and lists Moses Datson, Owner, as its authorized official.

NPPES Registry Identity

NPI1700179124

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameMADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC

Location Address295 MADISON AVE FL 28New York, NY 10017-6351

Mailing Address295 Madison Ave Fl 28New York, NY 10017-6351 · (212) 660-0305 · Fax (718) 284-5600

Phone(212) 660-0305

Organization SubpartNo

Authorized OfficialMoses DatsonOwner · (212) 660-0305

Enumeration DateMay 18, 2011

Last NPPES UpdateJuly 9, 2024

NPPES CertifiedJuly 9, 2024

✔ NPI 1700179124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in NY · 047288

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

295 MADISON AVE FL 28, New York, NY 10017

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Secondary Practice Location 1

Location 12025 Richmond Ave, Suite LL2Staten Island, NY 10314-3937 · Phone (718) 284-5500 · Fax (718) 284-5600

Other Identifiers 1

Medicaid02282231NY

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

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 Madison Avenue Oral Surgery And Implant Center, PC's NPI number?

The NPI number for Madison Avenue Oral Surgery And Implant Center, PC is 1700179124. It was assigned to this organization in the NPPES registry on May 18, 2011.

Where is Madison Avenue Oral Surgery And Implant Center, PC located?

Madison Avenue Oral Surgery And Implant Center, PC is located at 295 Madison Ave Fl 28, New York, NY 10017. The listed phone number is (212) 660-0305.

What is Madison Avenue Oral Surgery And Implant Center, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Madison Avenue Oral Surgery And Implant Center, PC was last updated on July 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.