Canarsie Modern Dentistry PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CANARSIE MODERN DENTISTRY PLLC

Practice address

9413 Flatlands Ave Ste 102W
Brooklyn, NY 11236-3713

Phone

(718) 257-0300

NPI assigned

Jul 17, 2024

Last updated

Aug 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Koorosh ShamtoubNPI 1205819919

Title

Owner

Phone

(718) 257-0300

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Koorosh Shamtoub, DDS

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1205819919
  NPD Authorized official

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1447098132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9413 FLATLANDS AVE STE 102W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363713",
            "telephone_number": "718-257-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9413 FLATLANDS AVE STE 102W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112363713",
            "telephone_number": "718-257-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANARSIE MODERN DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "SHAMTOUB",
        "authorized_official_first_name": "KOOROSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-257-0300"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Canarsie Childhood Center
• Canarsie Corp (Canarsie Plaza Pharmacy)
• Canarsie Dental Office
• Canarsie Eip, Inc.
• Canarsie Family & Cosmetic Dentistry PC
• Canarsie Optometry PC (Contemporary Eye Care)
• Canarsie Wellness Pharmacy Inc.
• Lellianne Canastra
• Frankie Cancel, LMHC, CASAC MASTER-G
• Gianmarco Cancelli, MD

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.