Bertha Dina Bravo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0442781 Issued in NY

Practice address

302 Greenwich Street
Hempstead, NY 11550

Phone

(516) 485-1145

Fax

(516) 485-8386

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Complete Dental PC

  • General Practice Dentistry
  • Hicksville, NY
  • NPI 1184896912
  NPD Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124155353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 GREENWICH STREET",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-485-1145",
            "fax_number": "516-485-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 GREENWICH STREET",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-485-1145",
            "fax_number": "516-485-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "BERTHA",
        "middle_name": "DINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0442781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01353584",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Octabia Boone
• Sabrina Borges, VRT/ OM
• Mellissa Anne Bortz
• Bri-Anna Bostic
• Claudia M. Boyle, LMHC
• Breaking Free Transitional Services
• Elena Brezina, MA, CCC, SLP
• Brilliance Dental of Long Island
• Grettel M Bromfield, RN
• Paula Rose Brooks-Obas, REGISTERED NURSE

• General Practice Dentistry in Hempstead, NY
• Providers in Hempstead, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.