NPIMap

Organization Active NPI

5TH Avenue Dental Assoc LLP

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1184742298
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
5TH AVENUE DENTAL ASSOC LLP
Practice address
7815 5TH Ave
Brooklyn, NY 11209-3703
Phone
(718) 745-4422
Fax
(718) 745-8558
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Authorized official

Name
George Diacoumakos
Title
Owner
Phone
(718) 745-4422

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

7815 5TH Ave
Brooklyn, NY 11209-3703

Mailing address

7815 5TH Ave
Brooklyn, NY 11209-3703
Phone (718) 745-4422

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1184742298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7815 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093703",
            "telephone_number": "718-745-4422",
            "fax_number": "718-745-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7815 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093703",
            "telephone_number": "718-745-4422",
            "fax_number": "718-745-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH AVENUE DENTAL ASSOC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "DIACOUMAKOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-745-4422"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 8, 2020; 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.