Aaa Brighton Dental Care PC

Primary specialty

DentistTaxonomy code 122300000X

License

046245 Issued in NY

Legal business name

AAA BRIGHTON DENTAL CARE PC

Practice address

123 Brighton Beach Ave FL 2
Brooklyn, NY 11235-8001

Phone

(718) 946-9520

Fax

(718) 946-9240

NPI assigned

Feb 13, 2007

Organization subpart

No

Name

Dr. Gennadiy Tsibelman, DDS

Title

President

Phone

(718) 946-9520

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 10, 2008.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226275200000",
    "number": "1295877496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BRIGHTON BEACH AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358001",
            "telephone_number": "718-946-9520",
            "fax_number": "718-946-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BRIGHTON BEACH AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358001",
            "telephone_number": "718-946-9520",
            "fax_number": "718-946-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAA BRIGHTON DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2008-11-10",
        "status": "A",
        "authorized_official_last_name": "TSIBELMAN",
        "authorized_official_first_name": "GENNADIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-946-9520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01599742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2008; 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.