=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235277815
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GILBERT J. KRINGSTEIN DDS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HANSON PL 7TH FLOOR
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11243-2907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-638-2200
-----------------------------------------------------
Fax | 718-638-2286
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 HANSON PL 7TH FLOOR
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11243-2907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-638-2200
-----------------------------------------------------
Fax | 718-638-2286
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | DR. JOHN S. MCINTYRE
-----------------------------------------------------
Credential | D.M.D.
-----------------------------------------------------
Telephone | 718-638-2200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | 035159
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------