Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Park Avenue Dental Boutique, LLC

Organization Dentist · NPI 1316440266

Park Avenue Dental Boutique, LLC provides Dentist services in New York, New York. Licensed in New York. Registered with an NPI since 2018.

Licensed in
NY
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

104 E 74th St
New York, NY 10021-3544
Phone: (212) 369-2202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 0506391 (NY)

Record details

NPI number1316440266
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Warszawski — Secretary · (646) 455-8657
NPI enumeratedMarch 16, 2018
Last updated in NPPESMarch 16, 2018
Mailing address104 E 74th St, New York, NY 10021-3544

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