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NPI Code Detail

MEDICARE: BROOKLYN DENTAL GROUP, JEFFREY S. ROSENTHAL, DDS, INC.

MEDICARE: BROOKLYN DENTAL GROUP, JEFFREY S. ROSENTHAL, DDS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1952919714
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKLYN DENTAL GROUP, JEFFREY S. ROSENTHAL, DDS, INC.
Provider Business Mailing Address
First Line : 4163 PEARL RD.
Second Line :
City : CLEVELAND
State : OH
Zip : 44109
Country : US
Telephone Number : 216-860-0120
Fax Number : 216-860-0479
Provider Business Practice Location Address
First Line : 4163 PEARL RD.
Second Line :
City : CLEVELAND
State : OH
Zip : 44109
Country : US
Telephone Number : 216-860-0120
Fax Number : 216-860-0479
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : MRS. GEORGIA PAPANDROPOULOS
Credential :
Telephone Number : 216-860-0120
Provider Enumeration Date : 07/17/2020
Last Update Date : 07/12/2021

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Directions to “BROOKLYN DENTAL GROUP, JEFFREY S. ROSENTHAL, DDS, INC. ” Practice Location

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