NPIMap

Organization Active NPI

Avenue D Dental PLLC

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1396426177
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AVENUE D DENTAL PLLC
Practice address
4401 Avenue D
Brooklyn, NY 11203-5725
Phone
(718) 451-1888
NPI assigned
Jul 26, 2023
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Karen Medina
Title
RCM Manager
Phone
(718) 763-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

4401 Avenue D
Brooklyn, NY 11203-5725

Mailing address

4401 Avenue D
Brooklyn, NY 11203-5725

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1396426177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 AVENUE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 AVENUE D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035725",
            "telephone_number": "718-451-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE D DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "718-763-0505"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 26, 2023; 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.