Provider Demographics
NPI:1568962793
Name:DR. JOSHUA BRATT DMD PC
Entity Type:Organization
Organization Name:DR. JOSHUA BRATT DMD PC
Other - Org Name:JOSHUA BRATT DMD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-764-7333
Mailing Address - Street 1:143 N LONG BEACH RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4438
Mailing Address - Country:US
Mailing Address - Phone:516-764-7333
Mailing Address - Fax:
Practice Address - Street 1:143 N LONG BEACH RD STE 3
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4438
Practice Address - Country:US
Practice Address - Phone:516-764-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1093737231Medicaid
ME1053608521Medicaid