NPIMap

Organization Active NPI

Bluestar Dental Care

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1720156870
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049832-1 Issued in NY
Legal business name
BLUESTAR DENTAL CARE
Practice address
2110 Rockaway Pkwy
Brooklyn, NY 11236-5802
Phone
(718) 209-8500
Fax
(718) 942-4582
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Dr. Michael R Dagostino, DDS
Title
Director of Dental and Oral Med
Phone
(718) 209-8500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 049832-1 NY Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 049803-1 NY
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 047926-1 NY

Addresses

Primary practice location

2110 Rockaway Pkwy
Brooklyn, NY 11236-5802

Mailing address

2110 Rockaway Pkwy
Brooklyn, NY 11236-5802
Phone (718) 209-8500

Other identifiers 1

IdentifierTypeStateIssuer
02769157MedicaidNY

National Provider Directory

National Provider Directory

Locations

2110 Rockaway Pkwy
Brooklyn, NY 11236
Phone (718) 209-8500

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1720156870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365802",
            "telephone_number": "718-209-8500",
            "fax_number": "718-942-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 ROCKAWAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365802",
            "telephone_number": "718-209-8500",
            "fax_number": "718-942-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUESTAR DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "DAGOSTINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF DENTAL AND ORAL MED",
        "authorized_official_telephone_number": "718-209-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "049832-1",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "049803-1",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "047926-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02769157",
            "state": "NY"
        }
    ],
    "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 Mar 20, 2008; 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.