Individual provider Active NPI

William W Bongiorno, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1679888564
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
030397 Issued in NY
Practice address
1278 72ND St
Brooklyn, NY 11228-1505
Phone
(718) 680-1117
Fax
(718) 491-5536
NPI assigned
Aug 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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 030397 NY Primary

Addresses

Primary practice location

1278 72ND St
Brooklyn, NY 11228-1505

Mailing address

1278 72ND St
Brooklyn, NY 11228-1505
Phone (718) 680-1117

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
030397NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1679888564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281505",
            "telephone_number": "718-680-1117",
            "fax_number": "718-491-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1278 72ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281505",
            "telephone_number": "718-680-1117",
            "fax_number": "718-491-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "030397",
            "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 Aug 16, 2010; 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.