Ninth Avenue Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

037498-1 Issued in NY

Legal business name

NINTH AVENUE DENTAL P.C.

Practice address

4109 9TH Ave
Brooklyn, NY 11232-4001

Phone

(718) 435-6858

Fax

(718) 435-5017

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Weiss, DDS

Title

President

Phone

(718) 435-6858

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1437357928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 9TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112324001",
            "telephone_number": "718-435-6858",
            "fax_number": "718-435-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 9TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112324001",
            "telephone_number": "718-435-6858",
            "fax_number": "718-435-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINTH AVENUE DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-435-6858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "037498-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00823116",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.