Individual provider Active NPI

Vladislav Gerts, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1417023516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
050746 Issued in NY
Practice address
743 Washington Ave
Brooklyn, NY 11238-4503
Phone
(718) 638-6002
Fax
(718) 638-7085
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 050746 NY Primary

Addresses

Primary practice location

743 Washington Ave
Brooklyn, NY 11238-4503

Mailing address

743 Washington Ave
Brooklyn, NY 11238-4503
Phone (718) 638-6002

Other identifiers 1

IdentifierTypeStateIssuer
02413523MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050746NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vladislav Gerts DDS PC General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417023516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 WASHINGTON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384503",
            "telephone_number": "718-638-6002",
            "fax_number": "718-638-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 WASHINGTON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112384503",
            "telephone_number": "718-638-6002",
            "fax_number": "718-638-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERTS",
        "first_name": "VLADISLAV",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "050746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02413523",
            "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 Jul 8, 2007; 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.