NPIMap

Organization Active NPI

Lutheran Medical Center

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1649527516
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LUTHERAN MEDICAL CENTER
Practice address
150 55TH St
Dental Department
Brooklyn, NY 11220-2508
Phone
(718) 630-6875
NPI assigned
Aug 10, 2012
Organization subpart
Yes
Parent organization
LUTHERAN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Astrid Gonzalez
Title
Senior Vice President
Phone
(718) 630-8973

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

150 55TH St
Dental Department
Brooklyn, NY 11220-2508

Mailing address

5800 3Rd Ave
Managed Care Department
Brooklyn, NY 11220-3702

Other names 1

  • Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Med Ctr-Eeg12 organizations share this tax ID, including this one
Part of
Lutheran Med Ctr-Eeg

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1649527516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 3RD AVE",
            "address_2": "MANAGED CARE DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "DENTAL DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508",
            "telephone_number": "718-630-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN MEDICAL CENTER",
        "enumeration_date": "2012-08-10",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ASTRID",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "718-630-8973"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 10, 2012; 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.