NPIMap

Organization Active NPI

Ac Dental PLLC.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1093922114
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
047068 Issued in NY
Legal business name
AC DENTAL PLLC.
Practice address
612 60TH St
Brooklyn, NY 11220-4101
Phone
(646) 247-7367
NPI assigned
May 17, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Angela Lo, DDSNPI 1518187152
Title
Dentist
Phone
(646) 247-7367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 047068 NY Primary

Addresses

Primary practice location

612 60TH St
Brooklyn, NY 11220-4101

Mailing address

612 60TH St
Brooklyn, NY 11220-4101
Phone (646) 247-7367

Other identifiers 1

IdentifierTypeStateIssuer
01751239MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Ac Dental PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093922114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 60TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204101",
            "telephone_number": "646-247-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 60TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204101",
            "telephone_number": "646-247-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AC DENTAL PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "646-247-7367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01751239",
            "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 Aug 22, 2020; 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.