Provider Demographics
NPI:1851381859
Name:PREFERRED DENTAL CARE P.C.
Entity Type:Organization
Organization Name:PREFERRED DENTAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-373-0300
Mailing Address - Street 1:2423 MERMAID AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2256
Mailing Address - Country:US
Mailing Address - Phone:718-373-0300
Mailing Address - Fax:718-373-0570
Practice Address - Street 1:2423 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2256
Practice Address - Country:US
Practice Address - Phone:718-373-0300
Practice Address - Fax:718-373-0570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038037-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9179219OtherDORAL DENTAL PLAN
NY00812088Medicaid