NPIMap

Organization Active NPI

Willoughby Dental P.C.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1225364425
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
039086 Issued in NY
Legal business name
WILLOUGHBY DENTAL P.C.
Practice address
135 Lawrence St
2ND Floor
Brooklyn, NY 11201-5208
Phone
(718) 237-7888
Fax
(718) 237-8716
NPI assigned
Oct 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Authorized official

Name
Dr. Ezra Trachtenberg, DMDNPI 1881828176
Title
President
Phone
(718) 237-7888

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 039086 NY Primary

Addresses

Primary practice location

135 Lawrence St
2ND Floor
Brooklyn, NY 11201-5208

Mailing address

135 Lawrence St
2ND Floor
Brooklyn, NY 11201-5208
Phone (718) 237-7888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1225364425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 LAWRENCE ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015208",
            "telephone_number": "718-237-7888",
            "fax_number": "718-237-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 LAWRENCE ST",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015208",
            "telephone_number": "718-237-7888",
            "fax_number": "718-237-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOUGHBY DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "TRACHTENBERG",
        "authorized_official_first_name": "EZRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-237-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039086",
            "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 Oct 22, 2009; 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.