Organization Active NPI

Bay Ridge Smiles

  • Pediatric Dentistry
  • Brooklyn, NY
National Provider Identifier
1003245697
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BAY RIDGE SMILES
Practice address
9012 5TH Ave
Brooklyn Smiles
Brooklyn, NY 11209-5908
Phone
(718) 333-5898
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mohamed A-Janabi, DDS
Title
Owner
Phone
(718) 333-5898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

9012 5TH Ave
Brooklyn Smiles
Brooklyn, NY 11209-5908

Mailing address

9012 5TH Avenue
Brooklyn Smiles
Brooklyn, NY 11209
Phone (718) 333-5898

Other identifiers 1

IdentifierTypeStateIssuer
02955860MedicaidNY

National Provider Directory

National Provider Directory

Locations

9012 5th Ave
Brooklyn, NY 11209
Phone (718) 333-5898

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1003245697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 5TH AVENUE",
            "address_2": "BROOKLYN SMILES",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-333-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9012 5TH AVE",
            "address_2": "BROOKLYN SMILES",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095908",
            "telephone_number": "718-333-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY RIDGE SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "A-JANABI",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-333-5898",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02955860",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.