Individual provider Active NPI

Alvaro Preciado, D.D.S

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1780850842
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053108 Issued in NY
Practice address
447 Fulton St
Brooklyn, NY 11201-5207
Phone
(718) 875-3200
NPI assigned
May 7, 2008
Last updated
Feb 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN17714 FL
General Practice Dentistry 1223G0001X 053108 NY Primary
General Practice Dentistry 1223G0001X 009702 CT

Addresses

Primary practice location

447 Fulton St
Brooklyn, NY 11201-5207

Mailing address

214-30 46 Ave
2ND Floor
Bayside, NY 11361
Phone (347) 235-4100

Other identifiers 1

IdentifierTypeStateIssuer
02802748MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220000541 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5597046136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009702CTMDGeneral Practice Dentistry
DN17714FLMDGeneral Practice Dentistry
053108NYMDOncology Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1780850842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214-30 46 AVE",
            "address_2": "2ND FLOOR",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "11361",
            "telephone_number": "347-235-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015207",
            "telephone_number": "718-875-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRECIADO",
        "first_name": "ALVARO",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17714",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053108",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02802748",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.