Organization Active NPI

Georgetown Dental Services PC.

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1821330754
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
043984 Issued in NY
Legal business name
GEORGETOWN DENTAL SERVICES PC.
Practice address
784 Clarkson Ave
Brooklyn, NY 11203-2202
Phone
(718) 604-4500
Fax
(718) 604-2741
NPI assigned
Mar 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Authorized official

Name
Mrs. Elsa Felicia Abrams
Title
DDS.
Phone
(718) 604-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 043984 NY Primary

Addresses

Primary practice location

784 Clarkson Ave
Brooklyn, NY 11203-2202

Mailing address

784 Clarkson Ave
Brooklyn, NY 11203-2202
Phone (718) 604-4500

Other identifiers 1

IdentifierTypeStateIssuer
01336121MedicaidNY

National Provider Directory

National Provider Directory

Locations

784 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 604-4500

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363564800000",
    "number": "1821330754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032202",
            "telephone_number": "718-604-4500",
            "fax_number": "718-604-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032202",
            "telephone_number": "718-604-4500",
            "fax_number": "718-604-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN DENTAL SERVICES PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A",
        "authorized_official_last_name": "ABRAMS",
        "authorized_official_first_name": "ELSA",
        "authorized_official_middle_name": "FELICIA",
        "authorized_official_title_or_position": "DDS.",
        "authorized_official_telephone_number": "718-604-4500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "043984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01336121",
            "state": "NY"
        }
    ],
    "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 Mar 18, 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.