Active NPI
Gennadiy Kravets, D.M.D.
- Dentist
- Brooklyn, NY
National Provider Identifier
1144492687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 052594-1
- Practice address
- 202 Union Ave
Suite D
Brooklyn, NY 11211-7467 - Phone
- (718) 388-4613
- Fax
- (718) 388-4613
- NPI assigned
- Mar 25, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 052594-1 | NY | Primary |
Addresses
Primary practice location
202 Union Ave
Suite D
Brooklyn, NY 11211-7467
Mailing address
202 Union Ave
Suite D
Brooklyn, NY 11211-7467
Phone (718) 388-4613
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02721328 | Medicaid | NY |
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 |
|---|---|---|---|
| 052594-1 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopewell Smile LLC | Current | Accepting new patients | |
| All Bright Dental Spa PC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health Dentistry
- Hopewell, NJ
- NPI 1821803495
-
- Dentist
- Stamford, CT
- NPI 1922378322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206403200000",
"number": "1144492687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 UNION AVE",
"address_2": "SUITE D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112117467",
"telephone_number": "718-388-4613",
"fax_number": "718-388-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 UNION AVE",
"address_2": "SUITE D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112117467",
"telephone_number": "718-388-4613",
"fax_number": "718-388-4613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAVETS",
"first_name": "GENNADIY",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-25",
"last_updated": "2008-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "052594-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02721328",
"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 Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.