NPIMap

Organization Active NPI

Nyc Family Dental Care P.C.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1720409303
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054967 Issued in NY
Legal business name
NYC FAMILY DENTAL CARE P.C.
Practice address
3002 Mermaid Avenue
Brooklyn, NY 11224-2256
Phone
(718) 975-4475
Fax
(718) 975-4477
NPI assigned
Dec 26, 2013
Last updated
Dec 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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

Authorized official

Name
Anatoliy Konovalov, D.M.DNPI 1992018766
Title
President
Phone
(718) 975-4475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 054967 NY Primary

Addresses

Primary practice location

3002 Mermaid Avenue
Brooklyn, NY 11224-2256

Mailing address

3002 Mermaid Avenue
Brooklyn, NY 11224-2256
Phone (718) 975-4475

National Provider Directory

National Provider Directory

Locations

3002 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 975-4475

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388016000000",
    "number": "1720409303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 MERMAID AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242256",
            "telephone_number": "718-975-4475",
            "fax_number": "718-975-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 MERMAID AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242256",
            "telephone_number": "718-975-4475",
            "fax_number": "718-975-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC FAMILY DENTAL CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2013-12-26",
        "status": "A",
        "authorized_official_last_name": "KONOVALOV",
        "authorized_official_first_name": "ANATOLIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-975-4475",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054967",
            "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 Dec 26, 2013; 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.