Individual provider Active NPI

Oleg Drut, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brooklyn, NY
National Provider Identifier
1619987757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
047218-1 Issued in NY
Practice address
79 Avenue U
Brooklyn, NY 11223-3554
Phone
(718) 373-6707
Fax
(718) 373-6799
NPI assigned
Aug 9, 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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 047218-1 NY Primary

Addresses

Primary practice location

79 Avenue U
Brooklyn, NY 11223-3554

Mailing address

800 Palisade Ave Apt 22E
Fort Lee, NJ 07024-4111
Phone (201) 969-2960

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
047218-1NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
PA Orthodontics, Ppllc Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Avenue U Orthodontics, PLLC Orthodontics and Dentofacial Orthopedics PastSince Sep 6, 2020 Accepting new patients
Bushwick Orthodontics PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619987757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PALISADE AVE APT 22E",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244111",
            "telephone_number": "201-969-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233554",
            "telephone_number": "718-373-6707",
            "fax_number": "718-373-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUT",
        "first_name": "OLEG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "047218-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "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.