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EXECUTIVE DENTAL CARE PC
NPI 1073788717
Preferred Provider Organization in Brooklyn, NY

Active since April 24, 2008
8011 FIFTH AVENUE, 2ND FLOOR, BROOKLYN, NY 11209(718) 748-6847 Get Directions Write a Review

NPPES record last updated: April 24, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Executive Dental Care Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXECUTIVE DENTAL CARE PC (NPI 1073788717) is a healthcare organization registered as a preferred provider organization in Brooklyn, New York and active in the NPI registry since April 2008. The organization lists James M Wallett, General Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1073788717
Entity TypeOrganization
Primary Taxonomy305R00000X
Legal Business NameEXECUTIVE DENTAL CARE PC
Location Address8011 FIFTH AVENUE, 2ND FLOORBrooklyn, NY 11209
Mailing Address8011 Fifth Avenue, 2nd FloorBrooklyn, NY 11209 · (718) 748-6847
Phone(718) 748-6847
Organization SubpartNo
Authorized OfficialJames M WallettGeneral Dentist/owner · (718) 748-6847
Enumeration DateApril 24, 2008
✔ NPI 1073788717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreferred Provider OrganizationManaged Care Organizations
Taxonomy Code305R00000X
License✔ Licensed in NY · 036639
Definition
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
8011 FIFTH AVENUE, Brooklyn, NY 11209
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Other Identifiers 1

Medicaid00759435NY

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EXECUTIVE DENTAL CARE PC
Dentist
8011 FIFTH AVENUE, 2ND FLOOR
BROOKLYN, NY 11209
Kings County (718) 748-6847

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Executive Dental Care PC's NPI number?

The NPI number for Executive Dental Care PC is 1073788717. It was assigned to this organization in the NPPES registry on April 24, 2008.

Where is Executive Dental Care PC located?

Executive Dental Care PC is located at 8011 Fifth Avenue 2nd Floor, Brooklyn, NY 11209. The listed phone number is (718) 748-6847.

What is Executive Dental Care PC's specialty?

The primary specialty registered for this NPI is Preferred Provider Organization with taxonomy code 305R00000X.

When was this NPI record last updated?

The NPPES record for Executive Dental Care PC was last updated on April 24, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.