Provider Demographics
NPI:1215746938
Name:IAN ROSENGARTEN DDS PLLC
Entity type:Organization
Organization Name:IAN ROSENGARTEN DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENGARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-685-6714
Mailing Address - Street 1:1414 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHRUB OAK
Mailing Address - State:NY
Mailing Address - Zip Code:10588-1410
Mailing Address - Country:US
Mailing Address - Phone:914-685-6714
Mailing Address - Fax:914-732-9787
Practice Address - Street 1:1414 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SHRUB OAK
Practice Address - State:NY
Practice Address - Zip Code:10588-1410
Practice Address - Country:US
Practice Address - Phone:914-685-6714
Practice Address - Fax:914-732-9787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental