MEDICARE: BRIGHTWAY 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

General Provider Information

NPI Number	:	1497540215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHTWAY DENTAL PC

Provider Business Mailing Address
First Line	:	2004 CROMPOND RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4231
Country	:	US
Telephone Number	:	914-243-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 CROMPOND RD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4231
Country	:	US
Telephone Number	:	914-243-7777
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. KAREEM FATOUH
Credential	:	DDS
Telephone Number	:	914-924-2286

Provider Enumeration Date	:	04/11/2025
Last Update Date	:	04/11/2025

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Directions to “BRIGHTWAY DENTAL PC ” Practice Location

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