NPIMap

Organization Active NPI

Church Avenue Family Dental P.C

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1053584409
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050877 Issued in NY
Legal business name
CHURCH AVENUE FAMILY DENTAL P.C
Practice address
1025 Church Ave
Brooklyn, NY 11218-2711
Phone
(718) 469-6077
NPI assigned
Apr 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Farshid AssaderaghiNPI 1053539650
Title
D.D.S
Phone
(718) 469-6077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 050877 NY Primary

Addresses

Primary practice location

1025 Church Ave
Brooklyn, NY 11218-2711

Mailing address

1025 Church Ave
Brooklyn, NY 11218-2711
Phone (718) 469-6077

National Provider Directory

National Provider Directory

Locations

1025 Church Ave
Brooklyn, NY 11218
Phone (718) 469-6077

Practitioners & affiliated clinicians

Practitioners 2

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": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1053584409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182711",
            "telephone_number": "718-469-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112182711",
            "telephone_number": "718-469-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH AVENUE FAMILY DENTAL P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "ASSADERAGHI",
        "authorized_official_first_name": "FARSHID",
        "authorized_official_title_or_position": "D.D.S",
        "authorized_official_telephone_number": "718-469-6077"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050877",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 7, 2008; 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.