99 Nassau Ave Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

056907 Issued in NY

Legal business name

99 NASSAU AVE DENTAL PLLC

Doing business as

Dental Made Easy

Practice address

99 Nassau Ave
Brooklyn, NY 11222-3082

Phone

(718) 383-0024

NPI assigned

Feb 21, 2018

Last updated

Feb 21, 2018By 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

Dr. Rafael Boruchov, DDSNPI 1295169472

Title

Owner

Phone

(718) 507-7781

Specialties & licenses 1

Addresses

Other names 1

• Dental Made Easy Doing business as

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.

• Rafael Boruchov, DDS

  • Dentist
  • Forest Hills, NY
  • NPI 1295169472
  NPD Authorized official
• Mark Zafir, DDS

  • Dentist
  • Brooklyn, NY
  • NPI 1669823415
  NPD (past)

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1922509348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11620 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757055",
            "telephone_number": "718-507-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 NASSAU AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112223082",
            "telephone_number": "718-383-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "99 NASSAU AVE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "BORUCHOV",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-507-7781",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "056907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Made Easy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.