| New Leaf Dental | |
|
2200 85th St Apt 1a Brooklyn NY 11214-3351 | |
| (718) 236-1165 | |
| (347) 521-2363 |
| Full Name | New Leaf Dental |
|---|---|
| Speciality | Dentist |
| Location | 2200 85th St Apt 1a, Brooklyn, New York |
| Authorized Official Name and Position | Nidal Zahi Salameh (DENTIST) |
| Authorized Official Contact | 7182361165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Leaf Dental 2200 85th St Apt 1a Brooklyn NY 11214-3351 Ph: (718) 236-1165 | New Leaf Dental 2200 85th St Apt 1a Brooklyn NY 11214-3351 Ph: (718) 236-1165 |
| NPI Number | 1104323971 |
|---|---|
| Provider Enumeration Date | 04/09/2018 |
| Last Update Date | 08/19/2021 |
| Medicare PECOS PAC ID | 7517356967 |
|---|---|
| Medicare Enrollment ID | O20211105001431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104323971 | NPI | - | NPPES |
| 04516758 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 058508 (New York) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Nidal Salameh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043691157 PECOS PAC ID: 9931487253 Enrollment ID: I20200422001915 |
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