Individual provider Active NPI

Yang Qiu, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1386145464
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060448 Issued in NY
Practice address
771 55TH St
Brooklyn, NY 11220-3210
Phone
(718) 438-1718
NPI assigned
Feb 23, 2018
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 060448 NY Primary

Addresses

Primary practice location

771 55TH St
Brooklyn, NY 11220-3210

Mailing address

3808 Union St Ste 4C
Flushing, NY 11354-5670
Phone (718) 440-6603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128001622 NY Practitioner - Dentist 1951779867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060448NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Yang Qiu DDS PLLC General Practice CurrentSince Jul 14, 2022 Accepting new patients

Locations

3808 Union St
Ste 4C
Flushing, NY 11354
Phone (718) 440-6603

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1386145464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 UNION ST STE 4C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545670",
            "telephone_number": "718-440-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203210",
            "telephone_number": "718-438-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIU",
        "first_name": "YANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.