| Wyckoff Heights Dental Services P.c. | |
|
374 Stockholm St Brooklyn NY 11237-4006 | |
| (718) 963-7174 | |
| (718) 302-6744 |
| Full Name | Wyckoff Heights Dental Services P.c. |
|---|---|
| Speciality | Dentist |
| Location | 374 Stockholm St, Brooklyn, New York |
| Authorized Official Name and Position | Vali Gache (CFO) |
| Authorized Official Contact | 7182401795 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyckoff Heights Dental Services P.c. 374 Stockholm St Brooklyn NY 11237-4006 Ph: (718) 963-7174 | Wyckoff Heights Dental Services P.c. 374 Stockholm St Brooklyn NY 11237-4006 Ph: (718) 963-7174 |
| NPI Number | 1447298070 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 04/03/2019 |
| Medicare PECOS PAC ID | 0749402782 |
|---|---|
| Medicare Enrollment ID | O20141107000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447298070 | NPI | - | NPPES |
| 01894164 | Medicaid | NY |
| Provider Name | John S Mcintyre |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1992708689 PECOS PAC ID: 0648353938 Enrollment ID: I20080216000042 |
| Provider Name | Naeema Bhuiya |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1124024567 PECOS PAC ID: 4183883143 Enrollment ID: I20120309000617 |
| Provider Name | Karl Hoffman-egozcue |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932225463 PECOS PAC ID: 8123340775 Enrollment ID: I20141210000076 |
| Provider Name | Anthony Richards |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1164573432 PECOS PAC ID: 6901129980 Enrollment ID: I20141223001812 |
| Provider Name | Robert M Peskin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720118375 PECOS PAC ID: 7618290420 Enrollment ID: I20150102000241 |
| Provider Name | Oren Richman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1962720680 PECOS PAC ID: 0345564043 Enrollment ID: I20150129001537 |
| Provider Name | Camille Chiques |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417189853 PECOS PAC ID: 7810203403 Enrollment ID: I20150827000485 |
| Provider Name | Manali Kanitkar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1447475967 PECOS PAC ID: 8123056025 Enrollment ID: I20150831002829 |
| Provider Name | Sidney Sternberger |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285876805 PECOS PAC ID: 1951605955 Enrollment ID: I20160211002497 |
| Provider Name | Priscila Guzman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649640285 PECOS PAC ID: 4082913702 Enrollment ID: I20160502002291 |
| Provider Name | Melany Camacho |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578910071 PECOS PAC ID: 7719273366 Enrollment ID: I20160907001698 |
| Provider Name | Ariel Oscar Otero-rodriguez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1922364439 PECOS PAC ID: 2365716438 Enrollment ID: I20190417001500 |
| Provider Name | Stanley Michel |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821194408 PECOS PAC ID: 2567880750 Enrollment ID: I20200921002094 |
| Provider Name | Jaehee Yoon |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1841622503 PECOS PAC ID: 3375963937 Enrollment ID: I20201020001999 |
| Provider Name | Rabia Yilan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1992129738 PECOS PAC ID: 5193193472 Enrollment ID: I20221117000380 |
| Provider Name | Kevin Zhang |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1215430327 PECOS PAC ID: 6507202074 Enrollment ID: I20240307001220 |
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