Ldfcb Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LDFCB DENTISTRY

Doing business as

Pediatric Dentistry on Avenue U

Practice address

817 Avenue U
Brooklyn, NY 11223-4135

Phone

(718) 375-1700

Fax

(718) 375-3375

NPI assigned

Jul 19, 2022

Last updated

Jul 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Barry L Jacobson, DMDNPI 1538279625

Title

Credentialing Specialist

Phone

(845) 369-3703

Specialties & licenses 5

Addresses

Other names 1

• Pediatric Dentistry on Avenue U Doing business as

Tax ID family

Ldfcb Dentistry2 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.

• Ldfcb Dentistry

  dba Pediatric Dentistry of Bronx

  • Pediatric Dentistry
  • Bronx, NY
  • NPI 1245334564
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry L. Jacobson, DMD

  • Pediatric Dentistry
  • Flushing, NY
  • NPI 1538279625
  Authorized official Same address or phone
• Tarica Homchand, DDS

  • Pediatric Dentistry
  • Brooklyn, NY
  • NPI 1528590528
  NPD

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1851026397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N AIRMONT RD STE 22",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014242",
            "telephone_number": "845-369-3703",
            "fax_number": "845-369-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234135",
            "telephone_number": "718-375-1700",
            "fax_number": "718-375-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDFCB DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "845-369-3703",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry on Avenue U",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pediatric Dentistry on Avenue U",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.