Mermaid Dental Arts P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

054967 Issued in NY

Legal business name

MERMAID DENTAL ARTS P.C.

Practice address

2423 Mermaid Ave
Brooklyn, NY 11224-2374

Phone

(718) 373-0300

Fax

(718) 373-0570

NPI assigned

Oct 15, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Anatoliy Konovalov, D.M.D.

Title

Owner

Phone

(718) 373-0300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1548631609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242374",
            "telephone_number": "718-373-0300",
            "fax_number": "718-373-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242374",
            "telephone_number": "718-373-0300",
            "fax_number": "718-373-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERMAID DENTAL ARTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "KONOVALOV",
        "authorized_official_first_name": "ANATOLIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-373-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "054967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reena Merl Kenigsberg, MS CCC SLP
• Margo Bridget Merli, LCSW
• Lisa Ruth Merlin, M.D.
• Tatyana Merlinskaya, LCSW
• Temmi Merlis, LMSW
• Mermaid Management Inc
• Mermaid Manor Hfa
• Mermaid Medical Art'S PC
• Mermaid Medical PC
• Mermaid Medical Supply Inc

• 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 Oct 15, 2015; 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.