NPIMap

Organization Active NPI

Boss Dental

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1922014679
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047068 Issued in NY
Legal business name
BOSS DENTAL
Practice address
1501 Avenue U
Brooklyn, NY 11229-3807
Phone
(718) 336-4521
NPI assigned
Aug 1, 2006
Organization subpart
Yes
Parent organization
BOSS DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Angela Lo
Title
Dentist
Phone
(718) 336-4521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 047068 NY Primary

Addresses

Primary practice location

1501 Avenue U
Brooklyn, NY 11229-3807

Mailing address

1501 Avenue U
Brooklyn, NY 11229-3807
Phone (718) 336-4521

Other identifiers 1

IdentifierTypeStateIssuer
02618188MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Boss Dental6 organizations share this tax ID, including this one
Part of
Boss Dental

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1922014679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293807",
            "telephone_number": "718-336-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 AVENUE U",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112293807",
            "telephone_number": "718-336-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSS DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOSS DENTAL",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-336-4521"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02618188",
            "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 27, 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.