Organization Active NPI

Advanced Dental Care of Nyc PC

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1184940611
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052892 Issued in NY
Legal business name
ADVANCED DENTAL CARE OF NYC PC
Practice address
142 Joralemon St
6Ef
Brooklyn, NY 11201-4747
Phone
(718) 624-1970
NPI assigned
Apr 8, 2010
Last updated
Apr 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Authorized official

Name
Dr. Rabiel AmirianNPI 1114143963
Title
President
Phone
(718) 624-1970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 052892 NY Primary

Addresses

Primary practice location

142 Joralemon St
6Ef
Brooklyn, NY 11201-4747

Mailing address

142 Joralemon St
6Ef
Brooklyn, NY 11201-4747
Phone (718) 624-1970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170523002049 NY Part B Supplier - Clinic/Group Practice 1557638574 Receives reassigned benefits from 4 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

142 Joralemon St
#6
Brooklyn, NY 11201
Phone (718) 624-1970

Practitioners & affiliated clinicians

Practitioners 4

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": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1184940611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 JORALEMON ST",
            "address_2": "6EF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014747",
            "telephone_number": "718-624-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JORALEMON ST",
            "address_2": "6EF",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014747",
            "telephone_number": "718-624-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL CARE OF NYC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "AMIRIAN",
        "authorized_official_first_name": "RABIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-624-1970",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052892",
            "primary": true
        }
    ],
    "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 Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.