Provider Demographics
NPI:1700911682
Name:FIRST ALERT DENTAL CARE, P.C.
Entity Type:Organization
Organization Name:FIRST ALERT DENTAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ALERTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-776-1320
Mailing Address - Street 1:21854 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-1206
Mailing Address - Country:US
Mailing Address - Phone:718-776-1320
Mailing Address - Fax:
Practice Address - Street 1:21854 99TH AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-1206
Practice Address - Country:US
Practice Address - Phone:718-776-1320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044397-11223G0001X
NY045002-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01370410Medicaid
NY01531502Medicaid
NY02022897Medicaid