# 12TH STREET DENTAL PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013499052
- **Authorized official:** DR. DAVID JANASH DMD (PRESIDENT AND CEO)
- **Authorized official phone:** (917) 915-4504

## Contact information

- **Practice address:** 77 E 12TH ST, NEW YORK, NY 10003-5002
- **Practice address phone:** (917) 915-4504
- **Mailing address:** 30 CENTRAL PARK S RM 13C, NEW YORK, NY 10019-1646
- **Mailing address phone:** (212) 355-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | 051610 | NY | Yes |

## Other

- **Enumeration date:** 09/06/2018
- **Last updated:** 05/30/2024