Specialty Dental of Greenpoint, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0522391 Issued in NY

Legal business name

SPECIALTY DENTAL OF GREENPOINT, P.C.

Practice address

92 Norman Ave
Brooklyn, NY 11222-2934

Phone

(718) 383-0933

Fax

(718) 349-0930

NPI assigned

Jan 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles J Ptak Jr., D.D.S.NPI 1083629778

Title

President

Phone

(718) 383-0933

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Charles John Ptak Jr., D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Brooklyn, NY
  • NPI 1083629778
  NPD (past) Authorized official

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1750434809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 NORMAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112222934",
            "telephone_number": "718-383-0933",
            "fax_number": "718-349-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 NORMAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112222934",
            "telephone_number": "718-383-0933",
            "fax_number": "718-349-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY DENTAL OF GREENPOINT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PTAK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-383-0933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "0522391",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "034744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00782729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.