Bay Ridge Dental Group, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

049466 Issued in NY

Legal business name

BAY RIDGE DENTAL GROUP, P.C.

Practice address

8415 4TH Ave
A-16
Brooklyn, NY 11209-4654

Phone

(718) 836-1716

Fax

(718) 836-3642

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Oleg Kruglyansky, DDS

Title

Partner

Phone

(718) 836-1716

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Bay Ridge Dental Group PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bay Ridge Dental Group, P.C.

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1164564274
  NPD tax ID

Practitioners 1

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

• Vera Pavlova, DDS

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1477631455
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811030745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 4TH AVE",
            "address_2": "A-16",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094654",
            "telephone_number": "718-836-1716",
            "fax_number": "718-836-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 4TH AVE",
            "address_2": "A-16",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112094654",
            "telephone_number": "718-836-1716",
            "fax_number": "718-836-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY RIDGE DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRUGLYANSKY",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-836-1716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194310",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bay Ridge Chiropractic Healthcare PC
• Bay Ridge Chiropractic, Professional Corporation
• Bay Ridge Community Physical Therapy
• Bay Ridge Creations, Inc
• Bay Ridge Dental Group, P.C.
• Bay Ridge Dental Health PC
• Bay Ridge Endoscopy PLLC
• Bay Ridge Endoscopy Services PLLC
• Bay Ridge Eye & Retina Specialist
• Bay Ridge Family Health NP, PLLC

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• 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.