18TH Ave Professional Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

049610 Issued in NY

Legal business name

18TH AVE PROFESSIONAL DENTAL PC

Practice address

2171 68TH St FL 3
Brooklyn, NY 11204-4733

Phone

(347) 713-1828

Fax

(347) 713-1878

NPI assigned

Mar 31, 2008

Organization subpart

No

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

Authorized official

Name

Kenny H Ho, DDS

Title

DDS/Owner

Phone

(347) 713-1828

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Xiyao Liu, DENTAL HYGIENIST

  • Dental Hygienist
  • Brooklyn, NY
  • NPI 1942123914
  NPD (past)

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1154593150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 68TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044733",
            "telephone_number": "347-713-1828",
            "fax_number": "347-713-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 68TH ST FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112044733",
            "telephone_number": "347-713-1828",
            "fax_number": "347-713-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "18TH AVE PROFESSIONAL DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "HO",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "347-713-1828",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "049610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02320661",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.