NPIMap

Organization Active NPI

Brooklyn Periodontics and Implant Dentistry, P.C.

  • Periodontics
  • Brooklyn, NY
National Provider Identifier
1093958282
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
052187 Issued in NY
Legal business name
BROOKLYN PERIODONTICS AND IMPLANT DENTISTRY, P.C.
Practice address
185 Montague St
9TH Floor
Brooklyn, NY 11201-3600
Phone
(718) 643-1953
NPI assigned
Apr 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Authorized official

Name
Dr. Michael Zidile, D.D.S.
Title
Periodontist
Phone
(718) 643-1953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 052187 NY Primary

Addresses

Primary practice location

185 Montague St
9TH Floor
Brooklyn, NY 11201-3600

Mailing address

185 Montague St
9TH Floor
Brooklyn, NY 11201-3600
Phone (718) 643-1953

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1093958282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MONTAGUE ST",
            "address_2": "9TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013600",
            "telephone_number": "718-643-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MONTAGUE ST",
            "address_2": "9TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112013600",
            "telephone_number": "718-643-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN PERIODONTICS AND IMPLANT DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "ZIDILE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "718-643-1953",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "052187",
            "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 Oct 1, 2013; 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.