Bushwick Orthodontic Studio

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BUSHWICK ORTHODONTIC STUDIO

Practice address

203 Irving Ave FL 1
Brooklyn, NY 11237-8077

Phone

(347) 382-6861

NPI assigned

Jul 15, 2024

Last updated

Jul 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andres Gonzalez, DMDNPI 1740650340

Title

President

Phone

(347) 382-6861

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andres Gonzalez, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Brooklyn, NY
  • NPI 1740650340
  NPD Authorized official

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1679310882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 N HENRY ST APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112225055",
            "telephone_number": "305-450-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 IRVING AVE FL 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112378077",
            "telephone_number": "347-382-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHWICK ORTHODONTIC STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-382-6861",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanislav Bushik, MD
• Matthew Bushman
• Bushwick Center for Renal Dialysis, LLC
• Bushwick Economic Development Corp
• Bushwick Medical of New York LLC
• Bushwick Orthodontics PLLC (Diamond Braces)
• Bushwick Pharmacy, Inc.
• Bushwick Professional Medical Services of New York LLC
• Bushwick Quality Supplies LLC
• Bushwick Stuyvesant Heights Home Attendants, Inc.

• Dental Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.