NPIMap

Organization Active NPI

Sheepshead Bay Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
National Provider Identifier
1336256338
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
049375 Issued in NY
Legal business name
SHEEPSHEAD BAY ORAL SURGERY
Practice address
1918 Avenue U
Brooklyn, NY 11229-3906
Phone
(718) 743-5400
Fax
(718) 743-4125
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Boris Zats, DDSNPI 1134147770
Title
President
Phone
(718) 743-5400

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 049375 NY Primary

Addresses

Primary practice location

1918 Avenue U
Brooklyn, NY 11229-3906

Mailing address

1918 Avenue U
Brooklyn, NY 11229-3906
Phone (718) 743-5400

Other identifiers 1

IdentifierTypeStateIssuer
02598878MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Sheepshead Bay Oral Surgery2 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.

Locations

1918 Avenue U
Brooklyn, NY 11229
Phone (718) 743-5400

Practitioners & affiliated clinicians

Practitioners 4

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336256338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293906",
            "telephone_number": "718-743-5400",
            "fax_number": "718-743-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293906",
            "telephone_number": "718-743-5400",
            "fax_number": "718-743-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEEPSHEAD BAY ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZATS",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-743-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "049375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02598878",
            "state": "NY"
        }
    ],
    "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 Aug 22, 2020; 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.