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AVENUE D DENTAL PLLC

Company Details

Name: AVENUE D DENTAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 22 Mar 2023 (2 years ago)
Entity Number: 6802035
ZIP code: 11234
County: Kings
Place of Formation: New York
Address: 2215 hendrickson street, suite 1, BROOKLYN, NY, United States, 11234

DOS Process Agent

Name Role Address
c/o ALLSTATE CORPORATE SERVICES DOS Process Agent 2215 hendrickson street, suite 1, BROOKLYN, NY, United States, 11234

National Provider Identifier

NPI Number:
1396426177
Certification Date:
2023-07-26

Authorized Person:

Name:
KAREN MEDINA
Role:
RCM MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1223G0001X - General Practice Dentistry
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
230419001397 2023-03-22 ARTICLES OF ORGANIZATION 2023-03-22

Date of last update: 20 Mar 2025

Sources: New York Secretary of State