Premier Dental,PC

Primary specialty

DentistTaxonomy code 122300000X

License

00295143 Issued in NY

Legal business name

PREMIER DENTAL,PC

Practice address

1155 Broadway
Brooklyn, NY 11221-3025

Phone

(718) 241-8050

NPI assigned

Sep 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Lawrence J Bruckner, DDSNPI 1326183930

Title

President

Phone

(917) 602-9533

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Practitioners 1

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

• Lawrence J Bruckner, DDS

  • Dentist
  • Brooklyn, NY
  • NPI 1326183930
  NPD (past) Authorized official

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1962651687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MAXINE AVE",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118033606",
            "telephone_number": "917-602-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112213025",
            "telephone_number": "718-241-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "BRUCKNER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-602-9533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "00295143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Preizler, RDN, CDN
• Prem K Gupta MD PC
• Prem Pharmacy Corp.
• Premed Pharmacy Inc
• Premier Anesthesia Services, PLLC
• Premier Imaging Associates PLLC
• Premier Medical for Sport & Rehabilitation, P.C.
• Premier Medical Supplies Inc.
• Premier Nephrology Services PC
• Premier Pediatrics

• Dentist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.