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NPI Code Detail

MEDICARE: GREENPOINT DENTAL PLAZA PC

MEDICARE: GREENPOINT DENTAL PLAZA 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
11223G0001XGeneral Practice Dentistry0455491NY

General Provider Information

NPI Number : 1851624423
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREENPOINT DENTAL PLAZA PC
Provider Business Mailing Address
First Line : PO BOX 220292
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-0292
Country : US
Telephone Number : 718-389-8000
Fax Number : 718-389-8388
Provider Business Practice Location Address
First Line : 152 GREENPOINT AVE
Second Line : 2ND FLOOR
City : BROOKLYN
State : NY
Zip : 11222-2202
Country : US
Telephone Number : 718-389-8000
Fax Number : 718-389-8388
Authorized Official
Title or Position : OWNER
Name : DR. ISAAK GRINMAN
Credential : DDS
Telephone Number : 718-389-8000
Provider Enumeration Date : 09/14/2009
Last Update Date : 09/14/2009

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1871893768 — MS. ELLEN PATRICIA FLANAGAN PMHNP
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1992118491 — JON STANCIU MEDICAL SERVICES PC
Practice Location Address:
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Directions to “GREENPOINT DENTAL PLAZA PC ” Practice Location

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