Provider Demographics
NPI:1225334113
Name:PERLROTH, TATIANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:PERLROTH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 BROADWAY RM 1801
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10279-0810
Mailing Address - Country:US
Mailing Address - Phone:212-344-9317
Mailing Address - Fax:
Practice Address - Street 1:233 BROADWAY RM 1801
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10279-0810
Practice Address - Country:US
Practice Address - Phone:212-344-9317
Practice Address - Fax:212-344-6973
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0555991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty