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EDOUARD ETLIS DENTAL, P.C.
NPI 1952765828
Dentist - General Practice in Brooklyn, NY

Active since April 07, 2016
9516 CHURCH AVE, BROOKLYN, NY 11212(718) 495-8801 Get Directions Write a Review

NPPES record last updated: April 7, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edouard Etlis Dental, P.c. NPPES

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

EDOUARD ETLIS DENTAL, P.C. (NPI 1952765828) is a healthcare organization registered as a general practice in Brooklyn, New York and active in the NPI registry since April 2016. The organization lists Edouard Etlis, President, as its authorized official.

NPPES Registry Identity

NPI1952765828
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameEDOUARD ETLIS DENTAL, P.C.
Location Address9516 CHURCH AVEBrooklyn, NY 11212-2434
Mailing Address80 Foch AveStaten Island, NY 10305-4438 · Fax (718) 495-8803
Phone(718) 495-8801
Organization SubpartNo
Authorized OfficialEdouard EtlisPresident · (646) 512-2777
Enumeration DateApril 7, 2016
✔ NPI 1952765828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 047627
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
9516 CHURCH AVE, Brooklyn, NY 11212
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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 4

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

MARAT SHLIMOV
Technician/Technologist (Optician)
9516 CHURCH AVE
BROOKLYN, NY 11212
Kings County (718) 495-8801
MY OPTICIAN INC.
Technician/Technologist (Optician)
9516 CHURCH AVE
BROOKLYN, NY 11212
Kings County (718) 495-8801
MY DENTIST, P.C.
Dentist (General Practice)
9516 CHURCH AVE
BROOKLYN, NY 11212
Kings County (718) 495-8801
CLEAR VISION OPTOMETRY PC
Optometrist
9516 CHURCH AVE
BROOKLYN, NY 11212
Kings County (718) 495-8801

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 Edouard Etlis Dental, P.C.'s NPI number?

The NPI number for Edouard Etlis Dental, P.C. is 1952765828. It was assigned to this organization in the NPPES registry on April 7, 2016.

Where is Edouard Etlis Dental, P.C. located?

Edouard Etlis Dental, P.C. is located at 9516 Church Ave, Brooklyn, NY 11212. The listed phone number is (718) 495-8801.

What is Edouard Etlis Dental, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Edouard Etlis Dental, P.C. was last updated on April 7, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.