NPIMap

Organization Active NPI

Brooklyn Smile Dental Health Services

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1205229044
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36187 Issued in NY
Legal business name
BROOKLYN SMILE DENTAL HEALTH SERVICES
Practice address
9412 4TH Ave
Brooklyn, NY 11209-7301
Phone
(718) 745-3456
Fax
(718) 745-3205
NPI assigned
Mar 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Dr. Gary Herskovits, DDSNPI 1942376389
Title
Dentist
Phone
(718) 745-3456

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 36187 NY Primary
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X 36187 NY
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 46724 NY
Oral and Maxillofacial Radiology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0008X NY

Addresses

Primary practice location

9412 4TH Ave
Brooklyn, NY 11209-7301

Mailing address

9412 4TH Ave
Brooklyn, NY 11209-7301
Phone (718) 745-3456

National Provider Directory

National Provider Directory

Locations

9412 4th Ave
Brooklyn, NY 11209
Phone (718) 745-3456

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": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1205229044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9412 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097301",
            "telephone_number": "718-745-3456",
            "fax_number": "718-745-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9412 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097301",
            "telephone_number": "718-745-3456",
            "fax_number": "718-745-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN SMILE DENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "HERSKOVITS",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-745-3456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "36187",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "36187",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "46724",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "NY",
            "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 Mar 30, 2015; 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.