Active NPI
David W Fung
- General Practice Dentistry
- Brooklyn, NY
National Provider Identifier
1215613450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 064774
- Practice address
- 800 Poly PL
Brooklyn, NY 11209-7104 - Phone
- (212) 686-7500
- Fax
- (212) 951-3378
- NPI assigned
- Jun 22, 2023
- Last updated
- Feb 19, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 064774 | NY | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
800 Poly PL
Brooklyn, NY 11209-7104
Mailing address
800 Poly PL
Brooklyn, NY 11209-7104
Phone (212) 686-7500
Other practice location 1
1456 Fulton St
Brooklyn, NY 11216-2505
Phone (718) 636-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- New York University College of Dentistry, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1456 Fulton St
Brooklyn, NY 11216-2505
PO Box
Suite 5478
Pawtucket, RI 02862-5478
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064774 | NY | MD | Pharmacotherapy Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Brooklyn, NY
- NPI 1033178561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771459200000",
"number": "1215613450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "212-686-7500",
"fax_number": "212-951-3378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "212-686-7500",
"fax_number": "212-951-3378"
}
],
"practiceLocations": [
{
"address_1": "1456 Fulton St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112162505",
"country_code": "US",
"telephone_number": "718-636-4500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FUNG",
"first_name": "DAVID",
"middle_name": "W",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-22",
"last_updated": "2026-02-19",
"certification_date": "2026-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "064774",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"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 Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.