Individual provider Active NPI

Tricia Quartey-Sagaille, D.M.D

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1669795654
Registry record updated Jun 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055308 Issued in NY
Practice address
472 5TH Ave
Brooklyn, NY 11215-4004
Phone
(718) 965-1144
NPI assigned
Mar 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02432100 NJ
Dentist 122300000X 055308 NY Primary

Addresses

Primary practice location

472 5TH Ave
Brooklyn, NY 11215-4004

Mailing address

472 5TH Ave
Brooklyn, NY 11215-4004
Phone (718) 965-1144

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
I20111216000183 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698940849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02432100NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Breakdown, LLC Current Accepting new patients
Noble Dental Care, PC CurrentSince Jun 18, 2023 Accepting new patients
Noble Dental Care, PC Dentist CurrentSince Mar 28, 2021 Accepting new patients

Locations

472 5th Ave
Brooklyn, NY 11215
Phone (718) 965-1144

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": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686960000000",
    "number": "1669795654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154004",
            "telephone_number": "718-965-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154004",
            "telephone_number": "718-965-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARTEY-SAGAILLE",
        "first_name": "TRICIA",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2023-06-17",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02432100",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.