Coney Island Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CONEY ISLAND DENTAL P.C.

Practice address

2882 W 15TH St Uppr Level
Brooklyn, NY 11224-2770

Phone

(718) 336-1777

Fax

(718) 887-3959

NPI assigned

Jan 13, 2015

Organization subpart

No

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

Authorized official

Name

Yevgeny Pasechnik

Title

Manager

Phone

(718) 766-8883

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Serge Kupetz, DDS

  • Dentist
  • Spring, TX
  • NPI 1437250289

  General Practice, NY

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617926400000",
    "number": "1255720322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 W 15TH ST UPPR LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242770",
            "telephone_number": "718-336-1777",
            "fax_number": "718-887-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2882 W 15TH ST UPPR LEVEL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242770",
            "telephone_number": "718-336-1777",
            "fax_number": "718-887-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEY ISLAND DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A",
        "authorized_official_last_name": "PASECHNIK",
        "authorized_official_first_name": "YEVGENY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-766-8883"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nolan Blau Condron, MD
• Jean Lowry Conelli, RN
• Michael Conenna
• Coney Island CDT
• Coney Island Chemist Inc
• Coney Island Family Eyecare
• Coney Island Health Services, Inc.
• Coney Island Healthcare Medical P.C.
• Coney Island Hospital
• Coney Island Hospital

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.