Provider Demographics
NPI:1588049670
Name:GENTLE CARE PEDIATRIC DENTISTRY PC
Entity type:Organization
Organization Name:GENTLE CARE PEDIATRIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAISH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MARKOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-402-6980
Mailing Address - Street 1:50 DAYTON LN
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2859
Mailing Address - Country:US
Mailing Address - Phone:914-402-6980
Mailing Address - Fax:
Practice Address - Street 1:50 DAYTON LN
Practice Address - Street 2:SUITE #103
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2859
Practice Address - Country:US
Practice Address - Phone:914-402-6980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty