Vladimir Bukrinsky, D.D.S.

Key facts

NPI

1003006446

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

045247 (NY)

Practice address

1632 E 18TH St
Suite a-1
Brooklyn, NY 11229-1268

Phone

(718) 382-5565

Fax

(718) 382-5590

NPI assigned

Aug 1, 2007

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 1, 2007.

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1003006446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 E 18TH ST",
            "address_2": "SUITE A-1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291268",
            "telephone_number": "718-382-5565",
            "fax_number": "718-382-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 E 18TH ST",
            "address_2": "SUITE A-1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291268",
            "telephone_number": "718-382-5565",
            "fax_number": "718-382-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKRINSKY",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01512876",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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