Active NPI
Marc Bongard, DMD
- Dental Anesthesiology
- Brooklyn, NY
National Provider Identifier
1972910479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- P93870
- Practice address
- 150 55TH St
Brooklyn, NY 11220-2508 - Phone
- (718) 630-7000
- NPI assigned
- Jul 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | P93870 | NY | Primary |
Addresses
Primary practice location
150 55TH St
Brooklyn, NY 11220-2508
Mailing address
277 Gold St
Apt 7H
Brooklyn, NY 11201-3114
Phone (857) 488-6131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P93870 | NY | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1972910479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "277 GOLD ST",
"address_2": "APT 7H",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112013114",
"telephone_number": "857-488-6131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 55TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112202508",
"telephone_number": "718-630-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONGARD",
"first_name": "MARC",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-16",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "NY",
"license": "P93870",
"primary": true
}
],
"identifiers": [],
"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 Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.