Provider Demographics
NPI:1548431265
Name:NEIGHBORHOOD DENTAL
Entity Type:Organization
Organization Name:NEIGHBORHOOD DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLAPIETRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-963-9500
Mailing Address - Street 1:795 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4107
Mailing Address - Country:US
Mailing Address - Phone:718-963-9500
Mailing Address - Fax:718-963-9553
Practice Address - Street 1:795 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4107
Practice Address - Country:US
Practice Address - Phone:718-963-9500
Practice Address - Fax:718-963-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045167-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0484697Medicaid