Church Ave Orthodontics, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DI20707 Issued in NJ

Legal business name

CHURCH AVE ORTHODONTICS, LLC

Practice address

2848 Church Ave
2ND Floor
Brooklyn, NY 11226-4106

Phone

(718) 282-8222

Fax

(718) 282-8244

NPI assigned

Feb 25, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Oleg Drut, DDS

Title

Owner

Phone

(718) 282-8222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1407096845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 CHURCH AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264106",
            "telephone_number": "718-282-8222",
            "fax_number": "718-282-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 CHURCH AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112264106",
            "telephone_number": "718-282-8222",
            "fax_number": "718-282-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH AVE ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "DRUT",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-282-8222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI20707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Chung, FNP
• Yoo Sun Kate Chung, DDS
• Eugene Chuprin-Levin
• Yana Chura
• Sarah Churba, NP
• Church Ave Pharmacy Inc
• Church Ave Pharmacy Inc
• Church Ave Pharmacy Inc LTC
• Church Avenue Dental P.C.
• Church Avenue Family Dental P.C

• Orthodontics and Dentofacial Orthopedics Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; 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.