Individual provider Active NPI

Tracey H Joseph, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1639149156
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048192 Issued in NY
Practice address
1655 Flatbush Ave
Suite A104
Brooklyn, NY 11210-3276
Phone
(718) 377-1319
Fax
(718) 377-1302
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 048192 NY Primary

Addresses

Primary practice location

1655 Flatbush Ave
Suite A104
Brooklyn, NY 11210-3276

Mailing address

1655 Flatbush Ave
Suite A104
Brooklyn, NY 11210-3276
Phone (718) 377-1319

Other identifiers 3

IdentifierTypeStateIssuer
1687857OtherNYUNITED CONCORDIA
01995862MedicaidNY
0013156OtherNYDORAL DENTAL NY INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811005809 NY Order and Referring Only - DentistPractitioner - Dentist 0749595361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048192NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tracey H Joseph DDS., PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639149156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 FLATBUSH AVE",
            "address_2": "SUITE A104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103276",
            "telephone_number": "718-377-1319",
            "fax_number": "718-377-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 FLATBUSH AVE",
            "address_2": "SUITE A104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112103276",
            "telephone_number": "718-377-1319",
            "fax_number": "718-377-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "TRACEY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1687857",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995862",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL NY INC",
            "identifier": "0013156",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.