Active NPI
Brock Saucy, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1053849752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 059868
- Practice address
- 834 Flatbush Ave
Brooklyn, NY 11226-3102 - Phone
- (718) 693-9811
- NPI assigned
- May 25, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 059868 | NY | Primary |
Addresses
Primary practice location
834 Flatbush Ave
Brooklyn, NY 11226-3102
Mailing address
160 Parkside Ave Apt 15C
Brooklyn, NY 11226-1248
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059868 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535846400000",
"number": "1053849752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 PARKSIDE AVE APT 15C",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112261248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 FLATBUSH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112263102",
"telephone_number": "718-693-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAUCY",
"first_name": "BROCK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-25",
"last_updated": "2018-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "059868",
"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 Sep 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.