Organization Active NPI

Victoria Dental Care PC

  • Dental Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1386937100
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
048733 Issued in NY
Legal business name
VICTORIA DENTAL CARE PC
Practice address
4224 18TH Ave
Brooklyn, NY 11218-5720
Phone
(718) 633-7135
Fax
(718) 437-1119
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Dr. Victoriya ShormanNPI 1093861338
Title
DDS
Phone
(718) 633-7135

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
Dental Clinic/Center 261QD0000X 048733 NY Primary

Addresses

Primary practice location

4224 18TH Ave
Brooklyn, NY 11218-5720

Mailing address

4224 18TH Ave
Brooklyn, NY 11218-5720
Phone (718) 633-7135

Other identifiers 1

IdentifierTypeStateIssuer
02072737MedicaidNY

National Provider Directory

National Provider Directory

Locations

4224 18th Ave
Brooklyn, NY 11218
Phone (718) 633-7135

Practitioners & affiliated clinicians

Practitioners 1

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": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1386937100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4224 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185720",
            "telephone_number": "718-633-7135",
            "fax_number": "718-437-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4224 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112185720",
            "telephone_number": "718-633-7135",
            "fax_number": "718-437-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "SHORMAN",
        "authorized_official_first_name": "VICTORIYA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "718-633-7135",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "048733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02072737",
            "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 May 26, 2011; 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.