| 3545 Johnson Blvd Dental Pc | |
|
1624 University Ave Bsmt Bronx NY 10453-6948 | |
| (718) 294-3725 | |
| Not Available |
| Full Name | 3545 Johnson Blvd Dental Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1624 University Ave Bsmt, Bronx, New York |
| Authorized Official Name and Position | Alejandro Leonel Williams (OWNER) |
| Authorized Official Contact | 7182943725 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 3545 Johnson Blvd Dental Pc 1624 University Ave Bsmt Bronx NY 10453-6948 Ph: (718) 294-3725 | 3545 Johnson Blvd Dental Pc 1624 University Ave Bsmt Bronx NY 10453-6948 Ph: (718) 294-3725 |
| NPI Number | 1124759527 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 08/28/2024 |
| Medicare PECOS PAC ID | 4981088762 |
|---|---|
| Medicare Enrollment ID | O20220827000242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124759527 | NPI | - | NPPES |
| 06804993 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Burt F Harvey |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578580361 PECOS PAC ID: 5890754667 Enrollment ID: I20041007000217 |
| Provider Name | Alejandro Leonel Williams |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073502217 PECOS PAC ID: 7911385612 Enrollment ID: I20220609000098 |
| Provider Name | Feliciano A Espaillat |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659547701 PECOS PAC ID: 8921489857 Enrollment ID: I20220722002075 |
| Provider Name | Christian Santana |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1104037613 PECOS PAC ID: 7416339635 Enrollment ID: I20220804003120 |
| Provider Name | Juan Pablo Collado |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1952390015 PECOS PAC ID: 2961885678 Enrollment ID: I20220812002229 |
| Provider Name | Eva Lebron |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497882716 PECOS PAC ID: 3678956380 Enrollment ID: I20220812002317 |
| Provider Name | Obianuju Okeke |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1730703265 PECOS PAC ID: 4385028117 Enrollment ID: I20220829001487 |
| Provider Name | Juan Solano |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548337967 PECOS PAC ID: 4183092745 Enrollment ID: I20221201003011 |
| Provider Name | Juan Bautista Espaillat |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194715425 PECOS PAC ID: 5991174062 Enrollment ID: I20221212002250 |
| Provider Name | John Finelli |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1437472792 PECOS PAC ID: 8325329063 Enrollment ID: I20221213000272 |
| Provider Name | Enrique Ficy Guillen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1932374121 PECOS PAC ID: 5496125791 Enrollment ID: I20230103000427 |
| Provider Name | Jose E Santana |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942344411 PECOS PAC ID: 7113398678 Enrollment ID: I20230119001477 |
| Provider Name | Nancy Mercedes Jimenez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1124179452 PECOS PAC ID: 1658743505 Enrollment ID: I20230202001917 |
| Provider Name | Marina Podlubny |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1023280690 PECOS PAC ID: 0547571820 Enrollment ID: I20230301000653 |
| Provider Name | Fernando Leon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093840712 PECOS PAC ID: 1052784170 Enrollment ID: I20230310000043 |
| Provider Name | Carlos Acosta |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1831412865 PECOS PAC ID: 8123386380 Enrollment ID: I20230315001668 |
| Provider Name | Manuel Galan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1619054947 PECOS PAC ID: 6406153204 Enrollment ID: I20230316001469 |
| Provider Name | Hector Bernabe |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1104815406 PECOS PAC ID: 2668778127 Enrollment ID: I20230605000457 |
| Provider Name | Yandresco Quintana |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1114187762 PECOS PAC ID: 7517286156 Enrollment ID: I20230619001177 |
| Provider Name | Hanna Hyun Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508333089 PECOS PAC ID: 8729439104 Enrollment ID: I20240110002067 |
Dc Dental Office, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2925 Grand Concourse, Suite 1a, Bronx, NY 10468 Phone: 718-329-4111 Fax: 718-329-1614 | |
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Jarrett Dental Pediatrics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1516 Jarret Pl, Bronx, NY 10461 Phone: 888-700-6623 Fax: 718-515-5419 | |
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Pradhan And Pradhan Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 White Plains Rd, Bronx, NY 10466 Phone: 718-652-6622 | |
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