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FOURTH AVENUE DENTAL
NPI 1881993392
Dentist - Oral and Maxillofacial Surgery in Brooklyn, NY

Active since March 23, 2011
5404 4TH AVE, BROOKLYN, NY 11220(718) 439-2876(718) 439-2879 Get Directions Write a Review

NPPES record last updated: August 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fourth Avenue Dental NPPES

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

FOURTH AVENUE DENTAL (NPI 1881993392) is a healthcare organization registered as an oral and maxillofacial surgery in Brooklyn, New York and active in the NPI registry since March 2011. The organization lists Andrew Maron, Dentist, as its authorized official.

NPPES Registry Identity

NPI1881993392
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameFOURTH AVENUE DENTAL
Location Address5404 4TH AVEBrooklyn, NY 11220-3006
Mailing Address5404 4th AveBrooklyn, NY 11220-3006 · (718) 439-2876 · Fax (718) 439-2879
Phone(718) 439-2876
Fax(718) 439-2879
Organization SubpartNo
Authorized OfficialAndrew MaronDentist · (718) 439-2876
Enumeration DateMarch 23, 2011
Last NPPES UpdateAugust 7, 2012
✔ NPI 1881993392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Also ListedDentistTaxonomy 122300000X
5404 4TH AVE, Brooklyn, NY 11220
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Other Identifiers 1

Medicaid03170656NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

4TH AVENUE DENTAL
Dentist (General Practice)
5404 4TH AVE
BROOKLYN, NY 11220
Kings County (718) 439-2876

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 Fourth Avenue Dental's NPI number?

The NPI number for Fourth Avenue Dental is 1881993392. It was assigned to this organization in the NPPES registry on March 23, 2011.

Where is Fourth Avenue Dental located?

Fourth Avenue Dental is located at 5404 4th Ave, Brooklyn, NY 11220. The listed phone number is (718) 439-2876.

What is Fourth Avenue Dental's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Fourth Avenue Dental was last updated on August 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.