Organization
WESTSIDE DENTIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNA BARANTSEVICH DDS (DENTIST)
(212) 247-5050
Entity
Organization
Contact information
Practice address
25 CENTRAL PARK W, SUITE 1C, NEW YORK, NY 10023-7253
(212) 247-5050
(212) 581-3596
Mailing address
25 CENTRAL PARK W, SUITE 1C, NEW YORK, NY 10023-7253
(212) 247-5050
(212) 581-3596
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
046914
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144354549
DENTIST
NY
Enumeration date
04/24/2007
Last updated
08/22/2020
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