Atlantic Terminal Dental, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046043 Issued in NY

Legal business name

ATLANTIC TERMINAL DENTAL, P.C.

Practice address

Atlantic Terminal Mall
139 Flatbush Avenue
Brooklyn, NY 11217

Phone

(718) 622-6100

Fax

(718) 622-7637

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Ross Krasnov

Title

Owner

Phone

(718) 622-6100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760699870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATLANTIC TERMINAL MALL",
            "address_2": "139 FLATBUSH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11217",
            "telephone_number": "718-622-6100",
            "fax_number": "718-622-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ATLANTIC TERMINAL MALL",
            "address_2": "139 FLATBUSH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11217",
            "telephone_number": "718-622-6100",
            "fax_number": "718-622-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC TERMINAL DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-622-6100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.