NPIMap

Organization Active NPI

Kings Plaza Dental PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brooklyn, NY
National Provider Identifier
1114938164
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
KINGS PLAZA DENTAL PC
Practice address
5412 Kings Plaza Mall
Brooklyn, NY 11234
Phone
(718) 258-0011
Fax
(718) 258-1405
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Alexander Mikhailov, DDS
Title
President
Phone
(718) 258-0011

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X NY
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X NY
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X NY Primary

Addresses

Primary practice location

5412 Kings Plaza Mall
Brooklyn, NY 11234

Mailing address

5412 Kings Plaza Mall
Brooklyn, NY 11234
Phone (718) 258-0011

Other identifiers 1

IdentifierTypeStateIssuer
02683732MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114938164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 KINGS PLAZA MALL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-258-0011",
            "fax_number": "718-258-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 KINGS PLAZA MALL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "718-258-0011",
            "fax_number": "718-258-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS PLAZA DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MIKHAILOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-258-0011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02683732",
            "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 Sep 11, 2025; 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.