Organization Active NPI

Ronald Deutsen DDS PC

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1144598590
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049859 Issued in NY
Legal business name
RONALD DEUTSEN DDS PC
Practice address
1122 Coney Island Ave
Brooklyn, NY 11230
Phone
(718) 253-2300
Fax
(718) 252-7910
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Authorized official

Name
Dr. Ronald Deutsen, DDS
Title
Principal Owner/Director
Phone
(718) 253-2300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049859 NY Primary
General Practice Dentistry 1223G0001X 049859 NY

Addresses

Primary practice location

1122 Coney Island Ave
Brooklyn, NY 11230

Mailing address

2016 Ave M
Brooklyn, NY 11210
Phone (718) 253-2300

Other identifiers 1

IdentifierTypeStateIssuer
02241858MedicaidNY

National Provider Directory

National Provider Directory

Locations

2016 Avenue M
Brooklyn, NY 11210
Phone (718) 253-2300

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": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1144598590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 AVE M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11210",
            "telephone_number": "718-253-2300",
            "fax_number": "718-252-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11230",
            "telephone_number": "718-253-2300",
            "fax_number": "718-252-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD DEUTSEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "DEUTSEN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRINCIPAL OWNER/DIRECTOR",
        "authorized_official_telephone_number": "718-253-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049859",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049859",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02241858",
            "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 Dec 13, 2011; 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.