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NPI Code Detail

MEDICARE: GLENWOOD DENTAL ASSOCIATES, PLLC

MEDICARE: GLENWOOD DENTAL ASSOCIATES, PLLC
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
11223G0001XGeneral Practice Dentistry038176NY

General Provider Information

NPI Number : 1639211600
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLENWOOD DENTAL ASSOCIATES, PLLC
Provider Business Mailing Address
First Line : 1569 RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3127
Country : US
Telephone Number : 718-251-7167
Fax Number : 718-251-7198
Provider Business Practice Location Address
First Line : 1569 RALPH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11236-3127
Country : US
Telephone Number : 718-251-7167
Fax Number : 718-251-7198
Authorized Official
Title or Position : OWNER
Name : DR. JOSHUA GINDEA
Credential : DDS
Telephone Number : 718-251-7167
Provider Enumeration Date : 02/13/2007
Last Update Date : 08/22/2020

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