Healthcare Provider Details

I. General information

NPI: 1508642067
Provider Name (Legal Business Name): MODERN DENTISTRY VAS OF BROOKLYN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1997 OCEAN AVE
BROOKLYN NY
11230-7385
US

IV. Provider business mailing address

355 OVINGTON AVE STE 100
BROOKLYN NY
11209-1457
US

V. Phone/Fax

Practice location:
  • Phone: 718-339-6000
  • Fax:
Mailing address:
  • Phone: 718-836-7109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. VINCENT ANTHONY SETTECASE SR.
Title or Position: PRESIDENT
Credential: DDS
Phone: 347-909-2848