43 Chruch Street Dental PC

Organization Active NPI Dental Clinic/Center · Bronx, NY

NPI 1356097869 · NPPES record last updated Aug 28, 2024

Key facts

NPI
1356097869
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
Legal business name
43 CHRUCH STREET DENTAL PC
Practice address
1776 Boston Rd Ste 1a
Bronx, NY 10460-4907
Phone
(347) 271-4840
Fax
(347) 271-4842
NPI assigned
Feb 23, 2022
Organization subpart
No

Authorized official

Name
Alejandro Leonel Williams, DDS NPI 1073502217
Title
Owner
Phone
(718) 294-3725

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 21

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220914000695 NY Part B Supplier - Clinic/Group Practice 5395120240 Receives reassigned benefits from 21 practitioners
Practice locations: Bronx, NY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Yes

Addresses

Primary practice location

1776 Boston Rd Ste 1a
Bronx, NY 10460-4907

Mailing address

1776 Boston Rd Ste 1a
Bronx, NY 10460-4907
Phone (347) 271-4840

Other providers in Bronx, NY

All providers in Bronx, NY · Dental Clinic/Center in New York

Sources for this page

Verify at the official NPI Registry.