765 Dental PC

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

045344 Issued in NY

Legal business name

765 DENTAL PC

Practice address

765 Nostrand Ave
Brooklyn, NY 11216

Phone

(718) 307-5660

Fax

(917) 737-7945

NPI assigned

May 4, 2010

Organization subpart

No

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

Authorized official

Name

Mark Goykhman

Title

General Manager

Phone

(718) 307-5660

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1497073233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11216",
            "telephone_number": "718-307-5660",
            "fax_number": "917-737-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11216",
            "telephone_number": "718-307-5660",
            "fax_number": "917-737-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "765 DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "GOYKHMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "718-307-5660"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "NY",
            "license": "045344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.