Healthcare Provider Details

I. General information

NPI: 1891666277
Provider Name (Legal Business Name): WEST BRIGHTON STUDIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2781 AMBOY RD
STATEN ISLAND NY
10306-2157
US

IV. Provider business mailing address

2781 AMBOY RD
STATEN ISLAND NY
10306-2157
US

V. Phone/Fax

Practice location:
  • Phone: 718-273-1101
  • Fax: 718-273-0308
Mailing address:
  • Phone: 718-273-1101
  • Fax: 718-273-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANIELLE MYERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 718-702-2347