MEDICARE: NEW CENTURY DENTAL PC

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
1	122300000X	Dentist		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326158981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW CENTURY DENTAL PC

Provider Business Mailing Address
First Line	:	2960 OCEAN AVE
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3202
Country	:	US
Telephone Number	:	718-621-0827
Fax Number	:	718-621-0829

Provider Business Practice Location Address
First Line	:	2960 OCEAN AVE
Second Line	:	1ST FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3202
Country	:	US
Telephone Number	:	718-621-0827
Fax Number	:	718-621-0829

Authorized Official
Title or Position	:	DENTIST
Name	:	ALEKSANDR G ONATSKIY
Credential	:	DDS
Telephone Number	:	718-621-0827

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/20/2014

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