4TH Avenue Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18369 Issued in NJ

Legal business name

4TH AVENUE DENTAL

Practice address

5404 4TH Ave
Brooklyn, NY 11220-3006

Phone

(718) 439-2876

Fax

(718) 439-2879

NPI assigned

Mar 6, 2012

Organization subpart

No

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

Authorized official

Name

Prof. Andrew Maron, DDS

Title

Owner

Phone

(718) 439-2876

Specialties & licenses 2

Addresses

Tax ID family

4TH Avenue Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fourth Avenue Dental

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
  • NPI 1881993392
  NPD tax ID

Locations

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1295009447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203006",
            "telephone_number": "718-439-2876",
            "fax_number": "718-439-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203006",
            "telephone_number": "718-439-2876",
            "fax_number": "718-439-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH AVENUE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-439-2876",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "18369",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "027990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 47TH Street Enterprise LLC
• 47TH Street Enterprise, LLC
• 482 Nyc Optical LLC
• 4N Medical Care PC
• 4TH Ave Pharmacy Inc.
• 5 Boroughs Diagnostic Testing Facility LLC
• 5 Boroughs Durable Medical Equipment LLC
• 50 Oceana Pharmacy Corp
• 500 Ocean Dental,P.C
• 5000 Avenue K Medical Assocs PC

• 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 Mar 6, 2012; 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.